1659377034 NPI number — TEL HAI RETIREMENT COMMUNITY

Table of content: (NPI 1659377034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659377034 NPI number — TEL HAI RETIREMENT COMMUNITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEL HAI RETIREMENT COMMUNITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659377034
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 TEL HAI CIR
Provider Second Line Business Mailing Address:
P O BOX 190
Provider Business Mailing Address City Name:
HONEY BROOK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19344-1271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-273-9333
Provider Business Mailing Address Fax Number:
610-273-4141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 TEL HAI CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONEY BROOK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19344-1271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-273-9333
Provider Business Practice Location Address Fax Number:
610-273-4141
Provider Enumeration Date:
06/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VERDEGEM
Authorized Official First Name:
M SUE
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VP OF FINANCE & ADMINISTRATI
Authorized Official Telephone Number:
610-273-9333

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  200102 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1008752500001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".