Healthcare Provider Details

I. General information

NPI: 1043372808
Provider Name (Legal Business Name): LEWES CONVALESCENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 MARKET ST
LEWES DE
19958-1308
US

IV. Provider business mailing address

440 MARKET ST
LEWES DE
19958-1308
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3030
  • Fax: 302-645-6120
Mailing address:
  • Phone: 302-645-3030
  • Fax: 302-645-6120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number565478
License Number StateDE

VIII. Authorized Official

Name: SHARON B KESTERSON
Title or Position: DIRECTOR OF PATIENT BUSINESS SERVIC
Credential:
Phone: 302-645-3210