Basic Information
| Provider Information | |||||||||
| NPI: | 1003305640 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAIRVIEW CARE CENTER OF PAPERMILL ROAD SNF LLC | ||||||||
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| OtherOrganizationName: | PAPERMILL ROAD NURSING AND REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 PAPER MILL RD | ||||||||
| Address2: | |||||||||
| City: | GLENSIDE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387833 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 850 PAPER MILL RD | ||||||||
| Address2: | |||||||||
| City: | GLENSIDE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152330920 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2018 | ||||||||
| LastUpdateDate: | 05/09/2018 | ||||||||
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| AuthorizedOfficialLastName: | STEG | ||||||||
| AuthorizedOfficialFirstName: | CHAIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9176278747 | ||||||||
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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.