Organization · NPI-2

35 Milkshake Lane Operations LLC

Skilled Nursing Facility · Annapolis, MD

NPI number1083896559
StatusActive
Last updated in NPPESJan 8, 2016

Details

NPI
1083896559
Entity type
Organization (NPI-2)
Legal business name
35 Milkshake Lane Operations LLC
Organization subpart
No
Enumeration date
Nov 27, 2007
Last updated
Jan 8, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility02-026MDYes

Other names

  • Spa Creek Center (Doing Business As)

Practice location

35 Milkshake Ln
Annapolis, MD 21403-1507

Phone 410-269-5100 · Fax 410-269-5453

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Phone 610-925-4436 · Fax 610-925-4351

Authorized official

Michael T. Berg
Assistant Secretary
5054684752

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