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General NPI Number Information
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NPI Number | 1154440667
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Entity Type | Organization
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Legal Business Name | HEARTLAND HEALTH CARE CENTER ADELPHI
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 1801 METZEROTT RD
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City | ADELPHI
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State | MD
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Zip | 20783-5101
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Country | US
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Telephone | 301-434-0500
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Fax | 301-434-6311
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Provider Business Mailing Address
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Address Line | 1801 METZEROTT RD
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City | ADELPHI
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State | MD
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Zip | 20783-5101
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Country | US
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Telephone | 301-434-0500
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Fax | 301-434-6311
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHARLES R WOODBERRY JR.
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Credential |
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Telephone | 301-434-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 16012
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License Number State | MD
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