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General NPI Number Information
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NPI Number | 1750386082
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Entity Type | Organization
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Legal Business Name | MGH COMMUNITY HEALTH, INC.
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 17735 GEORGIA AVE STE 010
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City | OLNEY
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State | MD
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Zip | 20832-2276
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Country | US
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Telephone | 301-570-7400
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Fax | 301-570-7420
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Provider Business Mailing Address
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Address Line | 4061 POWDER MILL RD SUITE 500
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City | CALVERTON
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State | MD
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Zip | 20705-3149
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Country | US
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Telephone | 301-931-3100
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Fax | 301-931-8580
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TRACI ANDERSON
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Credential |
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Telephone | 301-931-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R1084
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License Number State | MD
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