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General NPI Number Information
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NPI Number | 1679520662
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Entity Type | Organization
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Legal Business Name | RIDERWOOD VILLAGE, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 3120 GRACEFIELD ROAD ATTN: REHABILITATION MANAGER
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City | SILVER SPRING
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State | MD
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Zip | 20904-5810
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Country | US
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Telephone | 301-572-1300
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Fax | 410-204-7237
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Provider Business Mailing Address
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Address Line | 3140 GRACEFIELD ROAD ATTN: EXECUTIVE DIRECTOR
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City | SILVER SPRING
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State | MD
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Zip | 20904-1820
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Country | US
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Telephone | 301-572-1300
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Fax | 410-204-7237
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | JAMES K WALTER
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Credential |
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Telephone | 410-402-2315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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