- Enrollment id
- O20071203000165
- Enrollment state
- MD
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1649241068
- Multiple npi flag
- N
- Ccn
- 215117
- Associate id
- 9335139955
- Organization name
- STELLA MARIS INC
- Incorporation date
- 1953-08-01
- Incorporation state
- MD
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- STELLA MARIS, INC.
- Address line 1
- 2300 DULANEY VALLEY ROAD
- City
- TIMONIUM
- State
- MD
- Zip code
- 210932739