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General NPI Number Information
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NPI Number | 1073817946
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Entity Type | Organization
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Legal Business Name | RISING SUN FAMILY CARE CENTER, INC. DBA NAZARENE ADULT DAY CARE
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 2626 JACOB TOME HWY
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City | COLORA
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State | MD
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Zip | 21917-1214
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Country | US
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Telephone | 410-658-6000
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Fax | 410-658-0041
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Provider Business Mailing Address
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Address Line | 2626 JACOB TOME HWY
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City | COLORA
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State | MD
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Zip | 21917-1214
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Country | US
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Telephone | 410-658-6000
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Fax | 410-658-0041
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MISS GERALDINE YOLANDA NOCK
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Credential |
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Telephone | 410-658-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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