Healthcare Provider Details

I. General information

NPI: 1851103659
Provider Name (Legal Business Name): NH BV MAYS CHAPEL TENANT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12261 ROUNDWOOD ROAD
TIMONIUM MD
21093
US

IV. Provider business mailing address

12261 ROUNDWOOD ROAD
TIMONIUM MD
21093
US

V. Phone/Fax

Practice location:
  • Phone: 410-220-6967
  • Fax: 410-891-6200
Mailing address:
  • Phone: 410-220-6967
  • Fax: 410-891-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIAN ENGLE
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 410-962-0595