DEVEREUX FOUNDATION - WHITLOCK
Adult Care Home
Berwyn, Pennsylvania
Provider NPI: 1073645743
Organization Information:Organization Name: DEVEREUX FOUNDATION - WHITLOCK
Practice Location:
139 LEOPARD RD BERWYN, PA 19312 US
Tel: 610-296-6800 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
139 LEOPARD RD BERWYN, PA 19312 US
Tel: 610-296-6800 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | PA | 198110 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
1000019130005 | PA | 05 | |
1000019130006 | PA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin