Long Green Center

LBN: 115 East Melrose Avenue Operations Llc
Long Green Center is an health care organization with primary practice located at 115 E Melrose Ave , Baltimore MD 21212-2945. 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. 115 East Melrose Avenue Operations Llc can be contacted via phone (410) 435-9073, or through Berg, Michael T. via phone (505) 468-4752.

Contact Information

Primary practice address
115 E Melrose Ave Baltimore MD 21212-2945
Phone: (410) 435-9073
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berg, Michael T.
Phone: (505) 468-4752

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 30044 Maryland
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 30044 Maryland

Profile Details

NPI number 1235583600
LBN Legal business name 115 East Melrose Avenue Operations Llc
DBA Doing business as Long Green Center
Authorized official Berg, Michael T.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 21st, 2016
Last updated Sep 7th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235583600 NPPES
Maryland MEDICAID 442156600

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