Healthcare Provider Details

I. General information

NPI: 1578561049
Provider Name (Legal Business Name): PHOEBE BERKS HEALTH CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEIDELBERG DR
WERNERSVILLE PA
19565
US

IV. Provider business mailing address

1 READING DRIVE
WERNESVILLE PA
19565
US

V. Phone/Fax

Practice location:
  • Phone: 610-927-8574
  • Fax: 610-927-8422
Mailing address:
  • Phone: 610-927-8574
  • Fax: 610-927-8422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number324414
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number167802
License Number StatePA

VIII. Authorized Official

Name: MR. SCOTT R STEVENSON
Title or Position: CEO/CFO
Credential:
Phone: 610-794-5142