MEDICARE: HEBRON CARE CENTER 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1831971563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEBRON CARE CENTER INC

Provider Business Mailing Address
First Line	:	9522 PIAFFE CIR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-4681
Country	:	US
Telephone Number	:	240-846-5149
Fax Number	:	240-500-1753

Provider Business Practice Location Address
First Line	:	6812 MCCORMICK RD
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-4351
Country	:	US
Telephone Number	:	240-274-4040
Fax Number	:	240-500-1753

Authorized Official
Title or Position	:	ADMINISTRATOR / TREASURER
Name	:	CHARLES KWASI TUFUOR
Credential	:
Telephone Number	:	240-274-4040

Provider Enumeration Date	:	10/17/2023
Last Update Date	:	10/17/2023

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