Basic Information
| Provider Information | |||||||||
| NPI: | 1538658620 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRINTON MANOR CENTER SNF LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 549 BALTIMORE PIKE | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421020 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 549 BALTIMORE PIKE | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103586005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2018 | ||||||||
| LastUpdateDate: | 05/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | BIRNBAUM | ||||||||
| AuthorizedOfficialFirstName: | ISRAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 7329056440 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.