# THI OF PENNSYLVANIA AT BROOMALL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broomall Rehabilitation and Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245327428
- **Authorized official:** SUSAN ECCLES (PRESIDENT)
- **Authorized official phone:** (610) 356-0800

## Contact information

- **Practice address:** 50 N MALIN RD, BROOMALL, PA 19008-1429
- **Practice address phone:** (610) 356-0800
- **Practice address fax:** (610) 325-9499
- **Mailing address:** 930 RIDGEBROOK RD, SPARKS, MD 21152-9390
- **Mailing address phone:** (410) 773-1000

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2006
- **Last updated:** 11/06/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1957820 | — | PA |