Basic Information
| Provider Information | |||||||||
| NPI: | 1437104411 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BRINTON MANOR, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BRINTON MANOR | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | KENNETT SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193483109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109254436 | ||||||||
| FaxNumber: | 6109254351 | ||||||||
| Practice Location | |||||||||
| Address1: | 549 BALTIMORE PIKE | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103586005 | ||||||||
| FaxNumber: | 6103580993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | DROPESKEY | ||||||||
| AuthorizedOfficialFirstName: | JANE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CORPORATE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6109254231 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 033502 | PA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 0005659000 | 01 | AMERIHEALTH-MANAGED CARE | OTHER | 0005659000 | 01 | AMERIHEALTH-TRADITIONAL | OTHER | 110 | 01 | ELDER HEALTH | OTHER | 0005659000 | 01 | IBC-MANAGED CARE | OTHER | 460626 | 01 | AETNA-HMO | OTHER | IY0223 | 01 | HEALTHNET OF PA | OTHER | 395917 | 01 | HORIZON - SNF | OTHER | 0005659000 | 01 | IBC-TRADITIONAL | OTHER | 0014397270002 | 05 | PA | MEDICAID | 13364 | 01 | HEALTH PARTNERS | OTHER | 001040 | 01 | HORIZON - SUB | OTHER | 1027490 | 01 | KEYSTONE MERCY | OTHER | 255078 | 01 | HEALTH AMERICA | OTHER |