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Organization
PHILADELPHIA PROTESTANT HOME
Active
Organization
PHILADELPHIA PROTESTANT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WICKER (CFO)
(215) 697-8357
Entity
Organization
Contact information
Practice address
6500 TABOR RD, PHILADELPHIA, PA 19111-5332
(215) 697-8000
(215) 697-8018
Mailing address
6500 TABOR RD, PHILADELPHIA, PA 19111-5332
(215) 697-8000
(215) 697-8018
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
144500
PA
314000000X
Skilled Nursing Facility
Primary
681002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005698000
IBC
PA
05
—
0007494760001
—
PA
01
—
71-00802
EVERCARE
PA
Enumeration date
11/30/2005
Last updated
03/31/2016
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