Healthcare Provider Details

I. General information

NPI: 1477540524
Provider Name (Legal Business Name): LITTLE FLOWER MANOR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SPRINGFIELD RD
DARBY PA
19023-1115
US

IV. Provider business mailing address

1201 SPRINGFIELD RD
DARBY PA
19023-1115
US

V. Phone/Fax

Practice location:
  • Phone: 610-534-6000
  • Fax: 610-534-6027
Mailing address:
  • Phone: 610-534-6000
  • Fax: 610-534-6027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number121902
License Number StatePA

VIII. Authorized Official

Name: MS. MICHELE M SUBERS
Title or Position: CONTROLLER
Credential:
Phone: 610-534-6007