Healthcare Provider Details

I. General information

NPI: 1306830625
Provider Name (Legal Business Name): PRESBYTERIAN HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 MCKEE RD
DOVER DE
19904-2268
US

IV. Provider business mailing address

1 TRINITY DR E SUITE 201
DILLSBURG PA
17019-8522
US

V. Phone/Fax

Practice location:
  • Phone: 717-502-8595
  • Fax: 717-502-8840
Mailing address:
  • Phone: 717-502-8595
  • Fax: 717-502-8842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberDE00225
License Number StateDE

VIII. Authorized Official

Name: MRS. DONNA B CASNER
Title or Position: VP/CONTROLLER
Credential:
Phone: 717-502-8922