MEDICARE: LORIEN LIFE CENTER BALTIMORE COUNTY, INC.

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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1194889246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORIEN LIFE CENTER BALTIMORE COUNTY, INC.

Provider Business Mailing Address
First Line	:	3300 N RIDGE RD
Second Line	:	SUITE 390
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3383
Country	:	US
Telephone Number	:	410-252-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	12230 ROUNDWOOD ROAD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-3233
Country	:	US
Telephone Number	:	410-252-0880
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. NORMAN SNOWBERGER
Credential	:
Telephone Number	:	410-750-7500

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	08/22/2020

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