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NPI Code Detail

MEDICARE: XAVIER-CLINTON LLC

MEDICARE: XAVIER-CLINTON LLC
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
1314000000XSkilled Nursing Facility16001MD
2313M00000XNursing Facility/Intermediate Care Facility16001MD

General Provider Information

NPI Number : 1295732006
Entity Type Code : Organization
Provider Name (Legal Business Name) : XAVIER-CLINTON LLC
Provider Business Mailing Address
First Line : 9211 STUART LN
Second Line :
City : CLINTON
State : MD
Zip : 20735-2712
Country : US
Telephone Number : 301-868-3600
Fax Number : 301-868-5883
Provider Business Practice Location Address
First Line : 9211 STUART LN
Second Line :
City : CLINTON
State : MD
Zip : 20735-2712
Country : US
Telephone Number : 301-868-3600
Fax Number : 301-868-5883
Authorized Official
Title or Position : BOM
Name : MS. CHARLOTTE SKAGGS
Credential :
Telephone Number : 301-868-3600
Provider Enumeration Date : 07/07/2005
Last Update Date : 09/11/2025

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Directions to “XAVIER-CLINTON LLC ” Practice Location

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