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NPI Code Detail

MEDICARE: ATRIUM VILLAGE DEVELOPMENT, LLC

MEDICARE: ATRIUM VILLAGE DEVELOPMENT, 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
1310400000XAssisted Living Facility03AL695MD

General Provider Information

NPI Number : 1902851827
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATRIUM VILLAGE DEVELOPMENT, LLC
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 610-925-4436
Fax Number : 610-925-4351
Provider Business Practice Location Address
First Line : 4730 ATRIUM CT
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-3556
Country : US
Telephone Number : 410-363-0330
Fax Number : 410-363-8795
Authorized Official
Title or Position : CORPORATE DIRECTOR
Name : MARCELLA WILKINSON
Credential :
Telephone Number : 610-925-4045
Provider Enumeration Date : 05/23/2006
Last Update Date : 08/16/2007

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Directions to “ATRIUM VILLAGE DEVELOPMENT, LLC ” Practice Location

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