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General NPI Number Information
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NPI Number | 1497047310
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Entity Type | Organization
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Legal Business Name | CLIVEDEN NURSING AND REHABILITATION CENTER PA, LP
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 6400 GREENE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19119-3231
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Country | US
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Telephone | 410-923-2415
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Fax | 410-923-2416
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Provider Business Mailing Address
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Address Line | 1922 GREENSPRING DR SUITE 3
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City | TIMONIUM
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State | MD
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Zip | 21093-7603
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Country | US
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Telephone | 410-923-2415
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Fax | 410-923-2416
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTS RECEIVABLE
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Name | BARBARA MCADAMS
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Credential |
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Telephone | 410-923-2415
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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 | 330402
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License Number State | PA
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