# MCCLATCHY AVONDALE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bryn Mawr Terrace Convalscent Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013902667
- **Authorized official:** MR. MICHAEL MCCLATCHY (ADMINISTRATOR)
- **Authorized official phone:** (610) 525-8300

## Contact information

- **Practice address:** 773 E HAVERFORD RD, BRYN MAWR, PA 19010-3837
- **Practice address phone:** (610) 525-8300
- **Practice address fax:** (610) 519-0796
- **Mailing address:** 773 E HAVERFORD RD, BRYN MAWR, PA 19010-3837
- **Mailing address phone:** (610) 525-8300
- **Mailing address fax:** (610) 519-0796

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 123050 | PA | — |
| 314000000X | Skilled Nursing Facility | 023402 | PA | Yes |

## Other

- **Enumeration date:** 09/20/2005
- **Last updated:** 01/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0005902000 | IBC | PA |
| 01 | — | 0116091 | AETNA USHC | PA |
| 01 | — | 395095 | MEDICARE | PA |