MEDICARE: WHITE HORSE VILLAGE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	179430	PA
2	314000000X	Skilled Nursing Facility	235902	PA

General Provider Information

NPI Number	:	1518965946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE HORSE VILLAGE INC.

Provider Business Mailing Address
First Line	:	535 GRADYVILLE RD
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2815
Country	:	US
Telephone Number	:	610-558-5799
Fax Number	:	610-558-5001

Provider Business Practice Location Address
First Line	:	535 GRADYVILLE RD
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2815
Country	:	US
Telephone Number	:	610-558-5799
Fax Number	:	610-558-5001

Authorized Official
Title or Position	:	VP OF FINANCE AND CFO
Name	:	MARK WASSERMAN
Credential	:	CPA
Telephone Number	:	610-558-5799

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/13/2021

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Directions to “WHITE HORSE VILLAGE INC. ” Practice Location

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