OrganizationActive
1502 Frederick Road Opco LLC
NPI 1184373250 · Skilled Nursing Facility · Catonsville, MD
Provider details
- NPI number
- 1184373250
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Sam Stern, Cfo(877) 567-0402
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Respite Care385H00000X
Respite Care Facility
Nursing & Custodial Care Facilities
Practice location
1502 Frederick Rd
Catonsville, MD 21228-5019
Phone: (410) 747-3287
Approximate (ZIP-level) locationGet directions
Mailing address
14c 53rd St
Brooklyn, NY 11232-2644
Other names (DBA / former)
- Doing business as
- Autumn Lake Healthcare at Summit Park
Registry dates
- Enumerated
- 2022-03-23
- Last updated
- 2022-03-23
- Certified
- 2022-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.