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General NPI Number Information
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NPI Number | 1750611273
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Entity Type | Organization
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Legal Business Name | SHERWOOD MANOR RESIDENTIAL CARE
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 5521 PARK DR
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City | BOWIE
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State | MD
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Zip | 20715-4348
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Country | US
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Telephone | 202-320-1144
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Fax |
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Provider Business Mailing Address
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Address Line | 5521 PARK DR
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City | BOWIE
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State | MD
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Zip | 20715-4348
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Country | US
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Telephone | 202-320-1144
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Fax |
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Authorized Official
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Title or Position | ASSISTING LIVING MANAGER
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Name | FRED BROWN
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Credential |
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Telephone | 202-320-1144
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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 | 16AL0970-A
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License Number State | MD
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