Basic Information
| Provider Information | |||||||||
| NPI: | 1740265438 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2434 W BELVEDERE AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212155202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106012246 | ||||||||
| FaxNumber: | 4106012924 | ||||||||
| Practice Location | |||||||||
| Address1: | 2434 W BELVEDERE AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212155202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106012246 | ||||||||
| FaxNumber: | 4106012924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ELOUARDIGHI | ||||||||
| AuthorizedOfficialFirstName: | BRAHIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | ATTENDING PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2026022246 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | D63174 | MD | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.