Healthcare Provider Details

I. General information

NPI: 1174504062
Provider Name (Legal Business Name): KENDAL-CROSSLANDS COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E STREET RD
KENNETT SQUARE PA
19348-2028
US

IV. Provider business mailing address

PO BOX 100
KENNETT SQUARE PA
19348-0100
US

V. Phone/Fax

Practice location:
  • Phone: 610-388-5600
  • Fax: 610-388-5691
Mailing address:
  • Phone: 610-388-5608
  • Fax: 610-388-5691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StatePA

VIII. Authorized Official

Name: EDWARD PLASHA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 610-388-5666