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General NPI Number Information
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NPI Number | 1164530366
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Entity Type | Organization
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Legal Business Name | CLIVEDEN- MAPLEWOOD CONVALESCENT CENTER INC
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 125 W SCHOOL HOUSE LN
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City | PHILADELPHIA
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State | PA
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Zip | 19144-3348
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Country | US
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Telephone | 215-951-7630
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Fax | 215-844-8004
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Provider Business Mailing Address
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Address Line | 6950 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19119-2120
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Country | US
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Telephone | 215-951-7630
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Fax | 215-844-8004
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | MR. DONALD LEVESQUE
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Credential |
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Telephone | 215-951-4596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | PA
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