Shady Grove Center
LBN: 9701 Medical Center Drive Operations Llc
Shady Grove Center is an health care organization with primary practice located at 9701 Medical Center Dr , Rockville MD 20850-3326. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty.
9701 Medical Center Drive Operations Llc can be contacted via phone (301) 315-1900, or through Berg, Michael T. via phone (505) 468-4752.
Contact Information
Primary practice address
9701 Medical Center Dr
Rockville MD 20850-3326
Phone: (301) 315-1900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 15009 | Maryland |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 15009 | Maryland |
Profile Details
| NPI number | 1083068456 |
|---|---|
| LBN Legal business name | 9701 Medical Center Drive Operations Llc |
| DBA Doing business as | Shady Grove Center |
| Authorized official | Berg, Michael T. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 21st, 2016 |
| Last updated | Sep 7th, 2017 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083068456 | NPPES |
| Maryland | MEDICAID | 561102400 |
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