1760756415 NPI number — SOLOMAN HOLDINGS1 - THE TRIANGLE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760756415 NPI number — SOLOMAN HOLDINGS1 - THE TRIANGLE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOLOMAN HOLDINGS1 - THE TRIANGLE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BRIGHTON GARDENS OF COLUMBIA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760756415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7110 MINSTREL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045-5426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-884-0773
Provider Business Mailing Address Fax Number:
410-884-0776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7110 MINSTREL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045-5426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-884-0773
Provider Business Practice Location Address Fax Number:
410-884-0776
Provider Enumeration Date:
02/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
O'NEILL
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
410-884-0773

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  13AL138-H , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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