115 EAST MELROSE OPCO LLC
NPI 1043896814
Skilled Nursing Facility in Baltimore, MD

Active since March 22, 2021
115 E MELROSE AVE, BALTIMORE, MD 21212(877) 567-0402 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 115 East Melrose Opco Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

115 EAST MELROSE OPCO LLC (NPI 1043896814), doing business as Autumn Lake Healthcare At Long Green, is a healthcare organization registered as a skilled nursing facility in Baltimore, Maryland and active in the NPI registry since March 2021. The organization lists Sam Stern, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043896814
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name115 EAST MELROSE OPCO LLC
Location Address115 E MELROSE AVEBaltimore, MD 21212-2945
Mailing Address14c 53rd StBrooklyn, NY 11232-2644
Organization SubpartNo
Authorized OfficialSam SternCfo · (877) 567-0402
Enumeration DateMarch 22, 2021
NPPES CertifiedMarch 22, 2021
NPI 1043896814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X
Also ListedRespite CareTaxonomy 385H00000X
115 E MELROSE AVE, Baltimore, MD 21212

Other Names 1

Doing Business AsAutumn Lake Healthcare At Long Green

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
115 E MELROSE AVE
BALTIMORE, MD 21212
Physical Therapist
115 E MELROSE AVE
BALTIMORE, MD 21212
Occupational Therapy Assistant
115 E MELROSE AVE
BALTIMORE, MD 21212
Physical Therapist
115 E MELROSE AVE
BALTIMORE, MD 21212
Physical Therapy Assistant
115 E MELROSE AVE
BALTIMORE, MD 21212
Internal Medicine (Nephrology)
115 E MELROSE AVE
BALTIMORE, MD 21212
Speech-Language Pathologist
115 E MELROSE AVE
BALTIMORE, MD 21212
Internal Medicine
115 E MELROSE AVE
BALTIMORE, MD 21212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 115 East Melrose Opco LLC's NPI number?

The NPI number for 115 East Melrose Opco LLC is 1043896814. It was assigned to this organization in the NPPES registry on March 22, 2021. The provider is doing business as Autumn Lake Healthcare at Long Green.

Where is 115 East Melrose Opco LLC located?

115 East Melrose Opco LLC is located at 115 E Melrose Ave, Baltimore, MD 21212. The listed phone number is (877) 567-0402.

What is 115 East Melrose Opco LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for 115 East Melrose Opco LLC was last updated on March 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.