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General NPI Number Information
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NPI Number | 1982680633
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Entity Type | Organization
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Legal Business Name | SAINT MARTHA MANOR
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 470 MANOR AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2545
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Country | US
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Telephone | 610-873-8490
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Fax | 610-873-5684
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Provider Business Mailing Address
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Address Line | 470 MANOR AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-2545
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Country | US
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Telephone | 610-873-8490
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Fax | 610-873-5684
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MICHAEL CZEKNER
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Credential |
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Telephone | 215-368-0900
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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 | 457402
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License Number State | PA
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