# 2990 HOLME OPERATING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Immaculate Mary Center for Rehabilitation & Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134537426
- **Authorized official:** MR. CHARLES-EDOUARD GROS (MANAGER)
- **Authorized official phone:** (718) 360-8083

## Contact information

- **Practice address:** 2990 HOLME AVE, PHILADELPHIA, PA 19136-1830
- **Practice address phone:** (215) 335-2100
- **Mailing address:** 701 LANSDALE AVE, LANSDALE, PA 19446-2958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/30/2014
- **Last updated:** 07/30/2014