Healthcare Provider Details

I. General information

NPI: 1790005700
Provider Name (Legal Business Name): SENIOR CARE CENTERS OF PENNSYLVANIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 SPROUL RD SUITE 850
BROOMALL PA
19008-3512
US

IV. Provider business mailing address

6 NESHAMINY INTERPLEX SUITE 401
TREVOSE PA
19053-6964
US

V. Phone/Fax

Practice location:
  • Phone: 610-325-1600
  • Fax: 610-325-1495
Mailing address:
  • Phone: 215-642-6600
  • Fax: 215-642-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number304680
License Number StatePA

VIII. Authorized Official

Name: DEBORA HOCKENBURY
Title or Position: CONTRACTS MANAGER
Credential:
Phone: 215-642-6600