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NPI Code Detail

MEDICARE: HARRISON SENIOR LIVING OF GEORGETOWN, LLC

MEDICARE: HARRISON SENIOR LIVING OF GEORGETOWN, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1068DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417105305
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARRISON SENIOR LIVING OF GEORGETOWN, LLC
Provider Business Mailing Address
First Line : 110 W NORTH ST
Second Line :
City : GEORGETOWN
State : DE
Zip : 19947-2137
Country : US
Telephone Number : 302-856-4574
Fax Number : 302-856-3021
Provider Business Practice Location Address
First Line : 110 W NORTH ST
Second Line :
City : GEORGETOWN
State : DE
Zip : 19947-2137
Country : US
Telephone Number : 302-856-4574
Fax Number : 302-856-3021
Authorized Official
Title or Position : PRESIDENT
Name : CHRISTOPHER JOHN RICHETTI
Credential :
Telephone Number : 610-383-4225
Provider Enumeration Date : 09/04/2008
Last Update Date : 09/04/2008

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