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General NPI Number Information
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NPI Number | 1508854662
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Entity Type | Organization
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Legal Business Name | KESWICK MULTI CARE CENTER INC
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 700 W 40TH ST
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City | BALTIMORE
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State | MD
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Zip | 21211-2104
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Country | US
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Telephone | 410-235-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 700 W 40TH ST
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City | BALTIMORE
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State | MD
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Zip | 21211-2104
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Country | US
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Telephone | 410-235-8860
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BRET STINE
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Credential | AO
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Telephone | 410-662-4293
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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 | MD30039
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License Number State | MD
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