Healthcare Provider Details

I. General information

NPI: 1225017130
Provider Name (Legal Business Name): RIDGE CREST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 BUCK ROAD NORTH
FEASTERVILLE PA
19053
US

IV. Provider business mailing address

106 LAKESIDE DR
SOUTHAMPTON PA
18966
US

V. Phone/Fax

Practice location:
  • Phone: 215-355-3131
  • Fax: 215-355-0481
Mailing address:
  • Phone: 215-355-6288
  • Fax: 215-355-8127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number181102
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberA06720
License Number StatePA

VIII. Authorized Official

Name: MR. STANLEY J SEGAL
Title or Position: PRESIDENT
Credential: MHA
Phone: 215-355-6288