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NPI Code Detail

MEDICARE: CLIVEDEN OPERATING, LLC

MEDICARE: CLIVEDEN OPERATING, LLC
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1548704059
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLIVEDEN OPERATING, LLC
Provider Business Mailing Address
First Line : 22 DIKE DR
Second Line :
City : MONSEY
State : NY
Zip : 10952-1114
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6400 GREENE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-3231
Country : US
Telephone Number : 215-844-6400
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : JACOB ZAHLER
Credential :
Telephone Number : 908-912-2700
Provider Enumeration Date : 12/19/2016
Last Update Date : 03/01/2017

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Directions to “CLIVEDEN OPERATING, LLC ” Practice Location

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