1502 FREDERICK ROAD OPCO LLC
NPI 1184373250
Skilled Nursing Facility in Catonsville, MD

Active since March 23, 2022
1502 FREDERICK RD, CATONSVILLE, MD 21228(410) 747-3287 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 1502 Frederick Road Opco Llc NPPES

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

1502 FREDERICK ROAD OPCO LLC (NPI 1184373250), doing business as Autumn Lake Healthcare At Summit Park, is a healthcare organization registered as a skilled nursing facility in Catonsville, Maryland and active in the NPI registry since March 2022. The organization lists Sam Stern, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184373250
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name1502 FREDERICK ROAD OPCO LLC
Location Address1502 FREDERICK RDCatonsville, MD 21228-5019
Mailing Address14c 53rd StBrooklyn, NY 11232-2644 · (877) 567-0402
Organization SubpartNo
Authorized OfficialSam SternCfo · (877) 567-0402
Enumeration DateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
NPI 1184373250 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
1502 FREDERICK RD, Catonsville, MD 21228

Other Names 1

Doing Business AsAutumn Lake Healthcare At Summit Park

Other Providers at the Same Location NPPES 10

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

Registered Nurse
1502 FREDERICK RD
CATONSVILLE, MD 21228
Nurse Practitioner
1502 FREDERICK RD
CATONSVILLE, MD 21228
Physical Therapy Assistant
1502 FREDERICK RD
CATONSVILLE, MD 21228
Nurse Practitioner
1502 FREDERICK RD
CATONSVILLE, MD 21228
Skilled Nursing Facility
1502 FREDERICK RD
CATONSVILLE, MD 21228
Internal Medicine (Nephrology)
1502 FREDERICK RD
CATONSVILLE, MD 21228
Occupational Therapy Assistant
1502 FREDERICK RD
CATONSVILLE, MD 21228
Physical Therapy Assistant
1502 FREDERICK RD
CATONSVILLE, MD 21228

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 1502 Frederick Road Opco LLC's NPI number?

The NPI number for 1502 Frederick Road Opco LLC is 1184373250. It was assigned to this organization in the NPPES registry on March 23, 2022. The provider is doing business as Autumn Lake Healthcare at Summit Park.

Where is 1502 Frederick Road Opco LLC located?

1502 Frederick Road Opco LLC is located at 1502 Frederick Rd, Catonsville, MD 21228. The listed phone number is (410) 747-3287.

What is 1502 Frederick Road 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 1502 Frederick Road Opco LLC was last updated on March 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.