# FAIRMOUNT HOMES

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

## Provider details

- **NPI number:** 1568463818
- **Authorized official:** MR. JERRY D LILE (PRESIDENT/CEO)
- **Authorized official phone:** (717) 354-1800

## Contact information

- **Practice address:** 333 WHEAT RIDGE DR, EPHRATA, PA 17522-8558
- **Practice address phone:** (717) 354-1800
- **Practice address fax:** (717) 354-6665
- **Mailing address:** 333 WHEAT RIDGE DRIVE, EPHRATA, PA 17522-8558
- **Mailing address phone:** (717) 354-1800
- **Mailing address fax:** (717) 354-6665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060202 | PA | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 03/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007566860002 | — | PA |