Healthcare Provider Details

I. General information

NPI: 1063349256
Provider Name (Legal Business Name): WHISPERING PINES ALF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5811 S HAWTHORNE AVE
ROCK HALL MD
21661-1464
US

IV. Provider business mailing address

14920 OLD COLUMBIA PIKE
BURTONSVILLE MD
20866-1610
US

V. Phone/Fax

Practice location:
  • Phone: 410-639-7771
  • Fax: 301-476-7544
Mailing address:
  • Phone: 301-660-0060
  • Fax: 301-476-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: RAJU DATLA
Title or Position: MANAGER
Credential: PHD
Phone: 240-305-3484