Healthcare Provider Details

I. General information

NPI: 1629983630
Provider Name (Legal Business Name): COLUMBIA MEADOWS ASSISTED LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 GUILFORD RD
JESSUP MD
20794-9528
US

IV. Provider business mailing address

10210 GUILFORD RD
JESSUP MD
20794-9528
US

V. Phone/Fax

Practice location:
  • Phone: 240-459-2088
  • Fax: 240-540-6193
Mailing address:
  • Phone: 240-459-2088
  • Fax: 240-540-6193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KEVIN XU
Title or Position: OWNER
Credential:
Phone: 240-459-2088