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General NPI Number Information
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NPI Number | 1659022796
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Entity Type | Organization
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Legal Business Name | TUCKERMAN ASSISTED LIVING LLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 5550 TUCKERMAN LN
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City | ROCKVILLE
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State | MD
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Zip | 20852-4683
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Country | US
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Telephone | 732-903-1985
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 ROUTE 88 STE 301
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City | BRICK
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State | NJ
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Zip | 08724-3009
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Country | US
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Telephone | 732-903-1985
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MINDEE POSEN
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Credential |
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Telephone | 845-825-2217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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