MCCLATCHY AVONDALE CORPORATION
Assisted Living Facility
Bryn Mawr, Pennsylvania
Provider NPI: 1013902667
Organization Information:Organization Name: MCCLATCHY AVONDALE CORPORATION
Practice Location:
773 E HAVERFORD RD BRYN MAWR, PA 19010 US
Tel: 610-525-8300 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:
773 E HAVERFORD RD BRYN MAWR, PA 19010 US
Tel: 610-525-8300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | PA | 123050 |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | PA | 023402 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AETNA USHC | 0116091 | PA | 01 |
MEDICARE | 395095 | PA | 01 |
IBC | 0005902000 | PA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin