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General NPI Number Information
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NPI Number | 1184619736
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Entity Type | Organization
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Legal Business Name | HUMANGOOD PENNSYLVANIA
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1515 THE FAIRWAY
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City | JENKINTOWN
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State | PA
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Zip | 19046-1435
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Country | US
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Telephone | 215-885-6800
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Fax | 215-885-4560
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Provider Business Mailing Address
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Address Line | 2000 JOSHUA ROAD
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-2430
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Country | US
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Telephone | 610-828-4848
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Fax | 610-834-6556
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTS RECEIVABLE
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Name | GWEN ELLEN VANGELISTO
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Credential |
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Telephone | 949-463-0893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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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 | 182102
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License Number State | PA
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