Organization · Type 2 NPI

3415 Greencastle Road Opco LLC

Skilled Nursing Facility · Burtonsville, MD

NPI number 1003552480 Active

Practice location

3415 Greencastle Rd
Burtonsville, MD 20866-1715

Call (240) 970-5600 Map

Mailing address

14C 53rd St
Brooklyn, NY 11232-2644

Specialties and licenses

Taxonomy	Code	License
Nursing Facility/Intermediate Care Facility	313M00000X	None listed
Skilled Nursing Facility Primary	314000000X	None listed
Respite Care	385H00000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

13 other providers at this address

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NPI record

NPI: 1003552480
Entity type: Organization (Type 2)
Issued: May 9, 2022
Last updated: Sep 7, 2022
Status: Active

Other names

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Autumn Lake Healthcare at Oak Manor · doing business as
Autumn Lake Healthcare at Oak Manor · doing business as

Authorized official

Sam Stern
CFO
(877) 567-0402

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003552480

3415 Greencastle Road Opco LLC's National Provider Identifier is 1003552480, issued on May 9, 2022. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Burtonsville, MD. The record was last updated on Sep 7, 2022.