Basic Information
| Provider Information | |||||||||
| NPI: | 1104010495 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENERAL HEALTHCARE RESOURCES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1962 SW MCALLISTER LN | ||||||||
| Address2: | |||||||||
| City: | PORT ST LUCIE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349532063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7728079084 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2250 HICKORY RD STE 240 | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194622225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008794471 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2007 | ||||||||
| LastUpdateDate: | 08/30/2007 | ||||||||
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| AuthorizedOfficialLastName: | STROTHER | ||||||||
| AuthorizedOfficialFirstName: | JACQUELINE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | LPN | ||||||||
| AuthorizedOfficialTelephone: | 7728079084 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | PN5166432 | FL | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.