MEDICARE: ACUMEN CARE 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	310400000X	Assisted Living Facility	15ALO554-A	MD

General Provider Information

NPI Number	:	1730666546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUMEN CARE LLC

Provider Business Mailing Address
First Line	:	14725 GOOD HOPE RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-6020
Country	:	US
Telephone Number	:	301-661-8365
Fax Number	:

Provider Business Practice Location Address
First Line	:	14725 GOOD HOPE RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20905-6020
Country	:	US
Telephone Number	:	301-661-8365
Fax Number	:

Authorized Official
Title or Position	:	RN/MANAGER
Name	:	EZINNA ULOMA MBALEWE
Credential	:
Telephone Number	:	240-970-5310

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	08/17/2018

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