Healthcare Provider Details

I. General information

NPI: 1497336119
Provider Name (Legal Business Name): COMPLETE CARE AT BERKSHIRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 PERKIOMEN AVE
READING PA
19606-3633
US

IV. Provider business mailing address

5501 PERKIOMEN AVE
READING PA
19606-3633
US

V. Phone/Fax

Practice location:
  • Phone: 610-779-0600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHALOM STEIN
Title or Position: AUTHORIZED SIGNER
Credential:
Phone: 732-313-0880