- Enrollment id
- O20180212001856
- Enrollment state
- MD
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1972016905
- Multiple npi flag
- N
- Ccn
- 215364
- Associate id
- 5890055834
- Organization name
- PRINCE GEORGES POST ACUTE LLC
- Doing business as name
- FUTURECARE CAPITAL REGION
- Incorporation date
- 2013-08-01
- Incorporation state
- MD
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- FUTURE CARE CAPITAL REGION
- Affiliation entity name
- FUTURE CARE/LIFEBRIDGE HEALTH
- Affiliation entity id
- 232
- Address line 1
- 1051 BRIGHTSEAT ROAD
- City
- LANDOVER
- State
- MD
- Zip code
- 20785