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General NPI Number Information
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NPI Number | 1811101199
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Entity Type | Organization
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Legal Business Name | CAMILLA HALL NURSING HOME
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1145 KING ROAD
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City | IMMACULATA
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State | PA
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Zip | 19345-0100
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Country | US
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Telephone | 610-644-1152
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Fax | 610-695-0691
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Provider Business Mailing Address
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Address Line | 1145 KING ROAD
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City | IMMACULATA
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State | PA
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Zip | 19345-0100
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Country | US
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Telephone | 610-644-1152
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Fax | 610-695-0691
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARGARET BARBARA GRADL
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Credential |
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Telephone | 610-644-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NOT LICENSED
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License Number State |
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