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General NPI Number Information
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NPI Number | 1689097297
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Entity Type | Organization
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Legal Business Name | TAYLOR FARM ASSISTED LIVING INC.
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 21730 OSCAR HAYDEN RD
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City | BUSHWOOD
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State | MD
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Zip | 20618-2408
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Country | US
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Telephone | 301-769-3702
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Fax | 301-769-3429
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Provider Business Mailing Address
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Address Line | 21730 OSCAR HAYDEN RD
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City | BUSHWOOD
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State | MD
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Zip | 20618-2408
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Country | US
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Telephone | 301-769-3702
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Fax | 301-769-3429
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Authorized Official
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Title or Position | NURSE ADMINISTRATOR
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Name | MR. SHARON MARIE NICHOLSON
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Credential | LPN, CDP, WCC
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Telephone | 301-769-3702
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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 | 18AL0016-C
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 18AL0012E
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 18AL0015D
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 18AL0013-E
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License Number State | MD
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