- Enrollment id
- O20090701000186
- Enrollment state
- MD
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1750595518
- Multiple npi flag
- N
- Ccn
- 215200
- Associate id
- 3072664150
- Organization name
- BROOKE GROVE FOUNDATION, INC.
- Doing business as name
- BROOKE GROVE REHABILITATION & NURSING CENTER
- Incorporation date
- 1950-11-29
- Incorporation state
- MD
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- BROOKE GROVE REHAB. & NSG CTR
- Address line 1
- 18131 SLADE SCHOOL RD
- City
- SANDY SPRING
- State
- MD
- Zip code
- 208601346