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General NPI Number Information
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NPI Number | 1013902667
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Entity Type | Organization
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Legal Business Name | MCCLATCHY AVONDALE CORPORATION
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 773 E HAVERFORD RD
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City | BRYN MAWR
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State | PA
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Zip | 19010-3837
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Country | US
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Telephone | 610-525-8300
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Fax | 610-519-0796
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Provider Business Mailing Address
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Address Line | 773 E HAVERFORD RD
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City | BRYN MAWR
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State | PA
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Zip | 19010-3837
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Country | US
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Telephone | 610-525-8300
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Fax | 610-519-0796
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL MCCLATCHY
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Credential |
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Telephone | 610-525-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 123050
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 023402
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License Number State | PA
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