Provider Demographics
NPI:1346834124
Name:HEAL REST ASSISTED LIVING CARE SERVICES
Entity type:Organization
Organization Name:HEAL REST ASSISTED LIVING CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEDIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-354-3444
Mailing Address - Street 1:3632 YORKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3004
Mailing Address - Country:US
Mailing Address - Phone:240-816-0060
Mailing Address - Fax:240-816-0061
Practice Address - Street 1:201 MAJOR KING LN
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4795
Practice Address - Country:US
Practice Address - Phone:240-816-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEAL REST ASSISTED LIVING CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances