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General NPI Number Information
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NPI Number | 1568629434
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Entity Type | Organization
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Legal Business Name | BRITTANY MANOR LP
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 230 N 65TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-1006
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Country | US
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Telephone | 215-471-8224
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Fax | 215-471-8221
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Provider Business Mailing Address
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Address Line | 230 N 65TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-1006
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Country | US
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Telephone | 215-471-8224
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Fax | 215-471-8221
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. JOYLE SPEARS
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Credential |
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Telephone | 215-880-4641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 130151
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License Number State | PA
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