Healthcare Provider Details

I. General information

NPI: 1477508398
Provider Name (Legal Business Name): FOREST GLEN NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 BARKER ST
SILVER SPRING MD
20910-1001
US

IV. Provider business mailing address

2700 BARKER ST
SILVER SPRING MD
20910-1001
US

V. Phone/Fax

Practice location:
  • Phone: 410-458-9970
  • Fax:
Mailing address:
  • Phone: 410-458-9970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number814
License Number StateMD

VIII. Authorized Official

Name: MRS. AHUVA Y WEINREB
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-458-9970