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General NPI Number Information
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NPI Number | 1083241210
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Entity Type | Organization
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Legal Business Name | FAHRNEY-KEEDY MEMORIAL HOME, INC.
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 8560 SYMPHONY DRIVE
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City | BOONSBORO
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State | MD
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Zip | 21713
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Country | US
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Telephone | 301-671-5193
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Fax | 301-671-5239
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Provider Business Mailing Address
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Address Line | 8507 MAPLEVILLE ROAD
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City | BOONSBORO
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State | MD
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Zip | 21713
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Country | US
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Telephone | 301-733-6284
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Fax | 301-733-2733
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. STEPHEN P. COETZEE
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Credential | LNHA
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Telephone | 301-671-5017
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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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