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Organization
CHURCH LANE SENIOR SERVICES, LLC
Active
Organization
CHURCH LANE SENIOR SERVICES, LLC
Active
Other names
Brighten at Broomall
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. CALLAN (CHIEF FINANCIAL OFFICER)
(610) 527-4277
Entity
Organization
Contact information
Practice address
43 CHURCH LN, BROOMALL, PA 19008-2503
(610) 356-3003
(610) 353-5859
Mailing address
956 E RAILROAD AVE, BRYN MAWR, PA 19010-3831
(610) 525-8412
(610) 525-1371
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
023102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009799700001
—
PA
Enumeration date
05/31/2005
Last updated
08/22/2020
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