Basic Information
| Provider Information | |||||||||
| NPI: | 1366720088 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AURORA SENIOR LIVING OF MANOKIN, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11974 EDGEHILL TERRACE RD | ||||||||
| Address2: | |||||||||
| City: | PRINCESS ANNE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218532105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105434697 | ||||||||
| FaxNumber: | 4105434471 | ||||||||
| Practice Location | |||||||||
| Address1: | 11974 EDGEHILL TERRACE RD | ||||||||
| Address2: | |||||||||
| City: | PRINCESS ANNE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218532105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105434697 | ||||||||
| FaxNumber: | 4105434471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2011 | ||||||||
| LastUpdateDate: | 07/29/2011 | ||||||||
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| AuthorizedOfficialLastName: | OWENS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 4107298406 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.