# PARK LANE AT BELLINGHAM

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

## Provider details

- **NPI number:** 1760479109
- **Authorized official:** MR. DANA BEATTY NHA (ADMINISTRATOR)
- **Authorized official phone:** (484) 653-4420

## Contact information

- **Practice address:** 1615 E BOOT RD, WEST CHESTER, PA 19380-6001
- **Practice address phone:** (484) 653-4400
- **Practice address fax:** (484) 653-4401
- **Mailing address:** 1615 E BOOT RD, WEST CHESTER, PA 19380-6001
- **Mailing address phone:** (484) 653-4400
- **Mailing address fax:** (484) 653-4401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 01150201 | PA | Yes |

## Other

- **Enumeration date:** 09/30/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001273000 | BLUE CROSS ID | PA |