Provider Demographics
NPI:1497741524
Name:BRINTON WOODS HEALTH CARE CENTER LLC
Entity type:Organization
Organization Name:BRINTON WOODS HEALTH CARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SESSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-7238
Mailing Address - Street 1:10090 RED RUN BLVD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4827
Mailing Address - Country:US
Mailing Address - Phone:410-601-7238
Mailing Address - Fax:
Practice Address - Street 1:297 STONER AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2115
Practice Address - Country:US
Practice Address - Phone:410-795-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06-003313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407404100Medicaid
MD215247Medicare ID - Type Unspecified