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NPI Code Detail

MEDICARE: ALFREDHOUSE II

MEDICARE: ALFREDHOUSE II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility15AL084-GMD

General Provider Information

NPI Number : 1164858429
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALFREDHOUSE II
Provider Business Mailing Address
First Line : 18100 CASHELL RD
Second Line :
City : ROCKVILLE
State : MD
Zip : 20853-1031
Country : US
Telephone Number : 301-260-2080
Fax Number :
Provider Business Practice Location Address
First Line : 4 BROOMALL CT
Second Line :
City : SILVER SPRING
State : MD
Zip : 20906-3059
Country : US
Telephone Number : 301-260-2080
Fax Number :
Authorized Official
Title or Position : CEO AND ADMINISTRATOR
Name : DR. VEENA JITENDRA ALFRED
Credential : PH.D.
Telephone Number : 301-260-2080
Provider Enumeration Date : 09/18/2013
Last Update Date : 09/18/2013

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