MEDICARE: COLESVILLE ELDERCARE 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
1	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1477418507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLESVILLE ELDERCARE LLC

Provider Business Mailing Address
First Line	:	13304 BREGMAN RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-3440
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13304 BREGMAN RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-3440
Country	:	US
Telephone Number	:	301-789-4788
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GIGI BEKKAM
Credential	:
Telephone Number	:	301-789-4788

Provider Enumeration Date	:	12/20/2025
Last Update Date	:	12/20/2025

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