Provider Demographics
NPI:1366720088
Name:AURORA SENIOR LIVING OF MANOKIN, LLC
Entity type:Organization
Organization Name:AURORA SENIOR LIVING OF MANOKIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-729-8406
Mailing Address - Street 1:11974 EDGEHILL TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-2105
Mailing Address - Country:US
Mailing Address - Phone:410-543-4697
Mailing Address - Fax:410-543-4471
Practice Address - Street 1:11974 EDGEHILL TERRACE RD
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-2105
Practice Address - Country:US
Practice Address - Phone:410-543-4697
Practice Address - Fax:410-543-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility