Provider Demographics
NPI:1154567535
Name:KING FARM PRESBYTERIAN RETIREMENT COMMUNITY, INC.
Entity type:Organization
Organization Name:KING FARM PRESBYTERIAN RETIREMENT COMMUNITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-407-2055
Mailing Address - Street 1:701 KING FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5728
Mailing Address - Country:US
Mailing Address - Phone:240-499-9015
Mailing Address - Fax:240-499-9061
Practice Address - Street 1:701 KING FARM BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5728
Practice Address - Country:US
Practice Address - Phone:240-499-9015
Practice Address - Fax:240-499-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD215353Medicare Oscar/Certification