Healthcare Provider Details

I. General information

NPI: 1477418507
Provider Name (Legal Business Name): COLESVILLE ELDERCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13304 BREGMAN RD
SILVER SPRING MD
20904-3440
US

IV. Provider business mailing address

13304 BREGMAN RD
SILVER SPRING MD
20904-3440
US

V. Phone/Fax

Practice location:
  • Phone: 301-789-4788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: GIGI BEKKAM
Title or Position: CEO
Credential:
Phone: 301-789-4788