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General NPI Number Information
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NPI Number | 1740265438
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Entity Type | Organization
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Legal Business Name | LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 2434 W BELVEDERE AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5202
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Country | US
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Telephone | 410-601-2246
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Fax | 410-601-2924
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Provider Business Mailing Address
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Address Line | 2434 W BELVEDERE AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5202
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Country | US
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Telephone | 410-601-2246
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Fax | 410-601-2924
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | BRAHIM ELOUARDIGHI
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Credential | MD
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Telephone | 202-602-2246
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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 | D63174
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License Number State | MD
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