Provider Demographics
NPI:1487049987
Name:CAROLINE NURSING AND REHABILITATION CENTER, LLC
Entity type:Organization
Organization Name:CAROLINE NURSING AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:410-729-8406
Mailing Address - Street 1:520 KERR AVE
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-1343
Mailing Address - Country:US
Mailing Address - Phone:410-479-2130
Mailing Address - Fax:410-987-2430
Practice Address - Street 1:520 KERR AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1343
Practice Address - Country:US
Practice Address - Phone:410-479-2130
Practice Address - Fax:410-987-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility