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General NPI Number Information
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NPI Number | 1578505186
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Entity Type | Organization
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Legal Business Name | BREYUT CONVALESCENT CENTER, LLC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 2240 WHITEHORSE MERCERVILLE RD
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City | MERCERVILLE
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State | NJ
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Zip | 08619-2640
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Country | US
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Telephone | 609-586-7500
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Fax | 609-586-8932
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 610-925-4436
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Fax | 610-925-4351
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Authorized Official
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Title or Position | CORPORATE MANAGER
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Name | JANE DROPESKEY
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Credential |
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Telephone | 610-925-4231
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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 | 061106
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License Number State | NJ
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