ARLINGTON WEST CARE CENTER OPCO LLC (NPI# 1639649312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639649312 |
| Entity Type | Organization |
| Organization Name | ARLINGTON WEST CARE CENTER OPCO LLC |
| Other Organization Name | AUTUMN LAKE HEALTHCARE AT ARLINGTON WEST |
| Practice Address |
3939 Penhurst Ave Baltimore MD 21215-5632 |
| Mailing Address |
14c 53rd St Ste 220 Brooklyn NY 11232-2644 |
| Practice Telephone | 4106649535 |
| Mailing Telephone | 8775670402 |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | SAM STERN (CFO) |
| Authorized Official Telephone | 8775670402 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Autumn Lake Healthcare at Arlington West | Doing Business As Name - Organization |
| Street Address |
3939 PENHURST AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-5632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436885 | Haven Nursing Home, Inc | Nursing Facility/Intermediate Care Facility | 3939 Penhurst Ave, Baltimore, MD 21215-5632 | 2005-06-10 |
| 1861907727 | Njinkeng Violet Fomengia | Physical Therapist | 3939 Penhurst Ave, Baltimore, MD 21215-5632 | 2017-12-13 |
| 1659808004 | Emily Christine Hoskins | Speech-Language Pathologist | 3939 Penhurst Ave, Baltimore, MD 21215-5632 | 2017-05-16 |
| 1255789491 | Haven Nursing Home, Inc | Skilled Nursing Facility | 3939 Penhurst Ave, Baltimore, MD 21215-5632 | 2016-05-27 |
| 1568849958 | Healthpro Rehabilitation | Skilled Nursing Facility | 3939 Penhurst Ave, Baltimore, MA 21215 | 2015-05-05 |
| 1992898407 | Terrell Trent | Occupational Therapist | 3939 Penhurst Ave, Baltimore, MD 21215-5632 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578927489 | 1046 North Point, LLC | Skilled Nursing Facility | 1046 North Point Rd, Baltimore, MD 21224-3307 | 2016-04-06 |
| 1851770374 | Celia Alicia Akossiwa Essi Yovo | Skilled Nursing Facility | 4821 Belair Rd, Baltimore, MD 21206-5731 | 2015-05-29 |
| 1740555986 | Nissim S Rakhminov | Skilled Nursing Facility | 6716 Old Pimlico Rd, Baltimore, MD 21209-1612 | 2012-03-21 |
| 1962790717 | Blue Point Snf LLC | Skilled Nursing Facility | 2525 West Belvedere Ave, Baltimore, MD 21215 | 2011-07-14 |
| 1396044608 | Acc Green House Residences, Inc | Skilled Nursing Facility | 1010 E 33rd St, Baltimore, MD 21218-3636 | 2011-03-25 |
| 1811294226 | Mercy Villa Convent, Inc. | Skilled Nursing Facility | 6806 Bellona Ave, Baltimore, MD 21212-1219 | 2011-02-21 |
| 1972785004 | 1046 North Point, LLC | Skilled Nursing Facility | 1046 Old Northpoint Rd, Baltimore, MD 21224-3307 | 2007-11-30 |
| 1831310143 | The Wesley | Skilled Nursing Facility | 2211 W Rogers Ave, Baltimore, MD 21209-4424 | 2007-05-02 |
| 1760543367 | Aslc Opco Md I, LLC | Skilled Nursing Facility | 1300 Windlass Dr, Baltimore, MD 21220-4126 | 2006-12-13 |
| 1417045691 | Rock Glen Healthcare, Inc. | Skilled Nursing Facility | 10 N Rock Glen Rd, Baltimore, MD 21229-3250 | 2006-10-11 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.