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Organization
FAIRMOUNT HOMES
Active
Organization
FAIRMOUNT HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY D LILE (PRESIDENT/CEO)
(717) 354-1800
Entity
Organization
Contact information
Practice address
333 WHEAT RIDGE DR, EPHRATA, PA 17522-8558
(717) 354-1800
(717) 354-6665
Mailing address
333 WHEAT RIDGE DRIVE, EPHRATA, PA 17522-8558
(717) 354-1800
(717) 354-6665
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060202
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007566860002
—
PA
Enumeration date
08/09/2005
Last updated
03/02/2009
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