HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC (NPI# 1790795672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790795672 |
| Entity Type | Organization |
| Organization Name | HERMITAGE HEALTHCARE OF MANOKIN MANOR, LLC |
| Other Organization Name | MANOKIN MANOR NURSING & REHAB CTR. |
| Practice Address |
11974 Edgehill Terrace Rd Princess Anne MD 21853-2105 |
| Practice Telephone | 4106510011 |
| Practice Fax Number | 4105434471 |
| Mailing Telephone | 4106510011 |
| Mailing Fax Number | 4105434471 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BONNIE C. STONE (ADMINISTRATOR) |
| Authorized Official Telephone | 4106510011 |
| Authorized Official Credential | LICENSED ADMINIS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 19002 | 05 |
| Other Name | Type Code |
|---|---|
| Manokin Manor Nursing & Rehab Ctr. | Doing Business As Name - Organization |
| Street Address |
11974 EDGEHILL TERRACE RD |
| City | PRINCESS ANNE |
| State | MD |
| Zip Code | 21853-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023652757 | Marie T Swartz | Physical Therapist | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2019-11-06 |
| 1275181257 | Axis Health At Manokin Opco LLC | Skilled Nursing Facility | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2019-09-03 |
| 1851857809 | Lorraine Prosser Elliott | Occupational Therapist | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2019-02-14 |
| 1770049876 | April Jane Gumatas Corros | Physical Therapist | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2019-02-13 |
| 1134658107 | Clifford Francis Rideout IIi | Physical Therapist | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2017-06-05 |
| 1730467309 | Cassandra Joy Eck | Speech-Language Pathologist | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2011-07-29 |
| 1366720088 | Aurora Senior Living of Manokin, LLC | Skilled Nursing Facility | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2011-07-29 |
| 1962791442 | Gregorio M. Belloso M.d. P.a. | Family Medicine | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2011-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478013 | Zachary Castell | Counselor | 30665 Student Services Center Lane, Princess Anne, MD 21853 | 2019-10-14 |
| 1659798759 | Brittany Leigh Heffernan | Dentist | 12165 Elm Street, Princess Anne, MD 21853 | 2014-03-26 |
| 1750670519 | Earl Gene Grantz | Pharmacist | 1251 Brittingham Lane, Rite Aid Pharmacy, Princess Anne, MD 21853 | 2011-04-01 |
| 1356554018 | Somerset County Health Department | Public Health or Welfare | 11674 Somerset Avenue, Princess Anne, MD 21853 | 2007-05-08 |
| 1801008479 | Cedric Rashaw | Counselor | 1 Umes Backbone Road, Princess Anne, MD 21853 | 2007-05-04 |
| 1053408641 | Nancy V Lorsong | Nurse Practitioner | Backbone Rd, Charles Drew Student Health Center, Princess Anne, MD 21853 | 2006-10-06 |
| 1154354744 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm Street, Princess Anne, MD 21853 | 2006-07-08 |
| 1750855797 | Rebecca Coryell | Physician Assistant | 12302 Somerset Ave, Suite A, B, Princess Anne, MD 21853 | 2019-01-13 |
| 1205331840 | Kristen Lea Hyland | Dentist | 12165 Elm St, Princess Anne, MD 21853 | 2018-03-26 |
| 1386145118 | Karishma Dilip Patel | Dentist | 12165 Elm St, Princess Anne, MD 21853 | 2018-02-27 |
| Find all providers in zip 21853 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417596099 | Labil/ Labyem LLC. | Skilled Nursing Facility | 9233 Misting Ct, Waldorf, MD 20603-5724 | 2019-12-31 |
| 1750829495 | S.olani Yarl | Skilled Nursing Facility | 3622 Dean Dr, Suite N6, Hyattsville, MD 20782-1236 | 2017-02-02 |
| 1306295316 | Love One Home Healthcare,inc. | Skilled Nursing Facility | 1401 Mercantile Lane Suite 200j, Largo, MD 20774 | 2016-06-09 |
| 1538598735 | Mercy Care Providers, LLC | Skilled Nursing Facility | 4804 Continental Dr, Olney, MD 20832-2943 | 2013-11-07 |
| 1851615017 | Jps Health Services | Skilled Nursing Facility | 8116a Harford Rd, Baltimore, MD 21234 | 2010-03-17 |
| 1386979235 | Progressive Residential Nursing Care Services Inc | Skilled Nursing Facility | 1111 Kings Tree Dr, Bowie, MD 20721-1920 | 2009-10-10 |
| 1669601746 | Healing Vessels Inc | Skilled Nursing Facility | 911 Westlake Dr, Bowie, MD 20721-1850 | 2009-07-09 |
| 1881873057 | Devine Nursing Services Unlimited, Inc. | Skilled Nursing Facility | 4121 Sihler Oaks Trl, Owings Mills, MD 21117-5004 | 2007-10-24 |
| 1902819923 | Apnt, Inc. | Skilled Nursing Facility | 11584 Scaggsville Rd, Fulton, MD 20759-2206 | 2006-08-14 |
| 1053911925 | Abba Home Healthcare Solutions LLC | Skilled Nursing Facility | 1644 Annapolis Rd Ste 4, Odenton, MD 21113-1002 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | PRINCESS ANNE |
| Zip Code | 21853 |
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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.