Organization · NPI-2

6000 Bellona Opco LLC

Skilled Nursing Facility · Baltimore, MD

NPI number1326624198

StatusActive

Last updated in NPPESMar 22, 2021

Details

NPI: 1326624198
Entity type: Organization (NPI-2)
Legal business name: 6000 Bellona Opco LLC
Organization subpart: No
Enumeration date: Mar 22, 2021
Certification date: Mar 22, 2021
Last updated: Mar 22, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
314000000X	Skilled Nursing Facility	–	–	Yes
313M00000X	Nursing Facility/Intermediate Care Facility	–	–
385H00000X	Respite Care	–	–

Other names

Autumn Lake Healthcare At Homewood (Doing Business As)

Practice location

6000 Bellona Ave
Baltimore, MD 21212-2922

Phone 877-567-0402

Mailing address

14c 53rd St
Brooklyn, NY 11232-2644

Authorized official

Sam Stern
Cfo
8775670402

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