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General NPI Number Information
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NPI Number | 1235124579
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Entity Type | Organization
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Legal Business Name | HEBREW HOME OF GREATER WASHINGTON INC
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 6121 MONTROSE ROAD ATTN. FINANCE AND ACCOUTING DEPARTMENT
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City | ROCKVILLE
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State | MD
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Zip | 20852-4803
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Country | US
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Telephone | 301-770-8366
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Fax | 301-816-7747
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Provider Business Mailing Address
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Address Line | 6121 MONTROSE ROAD
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City | ROCKVILLE
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State | MD
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Zip | 20852-4803
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Country | US
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Telephone | 301-770-8366
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Fax | 301-770-8512
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Authorized Official
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Title or Position | COO
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Name | MR. BRUCE J. LEDERMAN
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Credential | J.D.
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Telephone | 301-770-8433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 15-015
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License Number State | MD
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