Organization · NPI-2

3330 Wilkens Avenue Operations LLC

Skilled Nursing Facility · Baltimore, MD

NPI number1619274545
StatusActive
Last updated in NPPESMar 7, 2018

Details

NPI
1619274545
Entity type
Organization (NPI-2)
Legal business name
3330 Wilkens Avenue Operations LLC
Organization subpart
No
Enumeration date
Feb 11, 2011
Last updated
Mar 7, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility30008MDYes
235Z00000X Speech-Language Pathologist,30008MD

Practice location

3330 Wilkens Ave
Baltimore, MD 21229-4610

Phone 410-525-1544 · Fax 410-646-4779

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Phone 610-925-4436 · Fax 610-347-4099

Authorized official

Michael T. Berg
Assistant Secretary
5054684752

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