Healthcare Provider Details

I. General information

NPI: 1033206388
Provider Name (Legal Business Name): RIDERWOOD VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 GRACEFIELD RD
SILVER SPRING MD
20904-5851
US

IV. Provider business mailing address

3140 GRACEFIELD RD
SILVER SPRING MD
20904-5851
US

V. Phone/Fax

Practice location:
  • Phone: 301-572-1300
  • Fax:
Mailing address:
  • Phone: 301-572-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SHARON SCHULZ
Title or Position: DIRECTOR OF SKILLED NURSING FAC.
Credential:
Phone: 410-402-2329