# PHILADELPHIA PROTESTANT HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477537827
- **Authorized official:** MR. DAVID WICKER (CFO)
- **Authorized official phone:** (215) 697-8357

## Contact information

- **Practice address:** 6500 TABOR RD, PHILADELPHIA, PA 19111-5332
- **Practice address phone:** (215) 697-8000
- **Practice address fax:** (215) 697-8018
- **Mailing address:** 6500 TABOR RD, PHILADELPHIA, PA 19111-5332
- **Mailing address phone:** (215) 697-8000
- **Mailing address fax:** (215) 697-8018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 144500 | PA | — |
| 314000000X | Skilled Nursing Facility | 681002 | PA | Yes |

## Other

- **Enumeration date:** 11/30/2005
- **Last updated:** 03/31/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0005698000 | IBC | PA |
| 05 | — | 0007494760001 | — | PA |
| 01 | — | 71-00802 | EVERCARE | PA |