1194889246 NPI number — LORIEN LIFE CENTER BALTIMORE COUNTY, INC.

Table of content: (NPI 1194889246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194889246 NPI number — LORIEN LIFE CENTER BALTIMORE COUNTY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LORIEN LIFE CENTER BALTIMORE COUNTY, INC.
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:
Provider Other Organization Name Type Code:
6
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:
1194889246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3300 N RIDGE RD
Provider Second Line Business Mailing Address:
SUITE 390
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21043-3383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-252-0880
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12230 ROUNDWOOD ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIMONIUM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-3233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-252-0880
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SNOWBERGER
Authorized Official First Name:
NORMAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
410-750-7500

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com