# SOUDERTON MENNONITE HOMES

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

## Provider details

- **NPI number:** 1871584409
- **Authorized official:** MR. EDWARD D. BRUBAKER (CEO)
- **Authorized official phone:** (215) 368-4438

## Contact information

- **Practice address:** 207 W SUMMIT ST, SOUDERTON, PA 18964-2054
- **Practice address phone:** (215) 723-9881
- **Practice address fax:** (215) 723-1442
- **Mailing address:** 207 W SUMMIT ST, SOUDERTON, PA 18964-2054
- **Mailing address phone:** (215) 723-9881
- **Mailing address fax:** (215) 723-1442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 050202 | PA | Yes |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 04/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0010170020001 | — | PA |