# WALLINGFORD NURSING AND REHABILITATION CENTER-WALLINGFORD PA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ProMedica Skilled Nursing and Rehabilitation (Wallingford)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669429288
- **Authorized official:** MR. MARTIN D ALLEN (DIRECTOR)
- **Authorized official phone:** (419) 252-5743

## Contact information

- **Practice address:** 115 S PROVIDENCE RD, WALLINGFORD, PA 19086-6333
- **Practice address phone:** (610) 565-3232
- **Practice address fax:** (610) 892-0830
- **Mailing address:** 333 N SUMMIT ST, TOLEDO, OH 43604-2615
- **Mailing address phone:** (419) 252-5500
- **Mailing address fax:** (877) 385-9446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 230102 | PA | Yes |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 01/31/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1020575240001 | — | PA |