# CHURCH LANE SENIOR SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brighten at Broomall
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194728493
- **Authorized official:** MR. MICHAEL J. CALLAN (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (610) 527-4277

## Contact information

- **Practice address:** 43 CHURCH LN, BROOMALL, PA 19008-2503
- **Practice address phone:** (610) 356-3003
- **Practice address fax:** (610) 353-5859
- **Mailing address:** 956 E RAILROAD AVE, BRYN MAWR, PA 19010-3831
- **Mailing address phone:** (610) 525-8412
- **Mailing address fax:** (610) 525-1371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 023102 | PA | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1009799700001 | — | PA |