1649689423 NPI number — CEDAR HAVEN ACQUISITION LLC

Table of content: (NPI 1649689423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649689423 NPI number — CEDAR HAVEN ACQUISITION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CEDAR HAVEN ACQUISITION LLC
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:
CEDAR HAVEN HEALTHCARE CENTER
Provider Other Organization Name Type Code:
3
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:
1649689423
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 DRYDEN RD E
Provider Second Line Business Mailing Address:
SUITE 3100
Provider Business Mailing Address City Name:
DRESHER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19025-1044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-441-7700
Provider Business Mailing Address Fax Number:
215-441-4255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
590 S 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-9195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-274-0421
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2014

Additional Information

Authorized Official

Authorized Official Last Name:
D'ARCANGELO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-441-7700

Provider Taxonomy Codes

  • Taxonomy code: 313M00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , 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)





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