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General NPI Number Information
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NPI Number | 1588877252
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Entity Type | Organization
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Legal Business Name | KESWICK
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/12/2008
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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 | 410-238-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 WALKER AVUE
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City | BALTIMORE
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State | MD
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Zip | 21239
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | LINDA PATE
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Credential |
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Telephone | 410-375-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 05836
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License Number State | MD
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