Provider Demographics
NPI:1053906073
Name:MCAP SALISBURY LLC
Entity type:Organization
Organization Name:MCAP SALISBURY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:LADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-566-1309
Mailing Address - Street 1:PO BOX 2064
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-2064
Mailing Address - Country:US
Mailing Address - Phone:434-566-1309
Mailing Address - Fax:434-322-3211
Practice Address - Street 1:611 TRESSLER DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7406
Practice Address - Country:US
Practice Address - Phone:410-860-8750
Practice Address - Fax:410-860-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility