# COUNTY OF CHESTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pocopson Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992704589
- **Authorized official:** MR. RAYMOND A LARSON (ADMINISTRATOR)
- **Authorized official phone:** (610) 793-1212

## Contact information

- **Practice address:** 1695 LENAPE RD, WEST CHESTER, PA 19382-6801
- **Practice address phone:** (610) 793-1212
- **Practice address fax:** (610) 793-2493
- **Mailing address:** 1695 LENAPE RD, WEST CHESTER, PA 19382-6800
- **Mailing address phone:** (610) 793-1212
- **Mailing address fax:** (610) 793-2493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 162002 | PA | Yes |

## Other

- **Enumeration date:** 07/18/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 005967 | KEYSTONE EAST PROVIDER \# | PA |
| 01 | — | 0445390001 | NSC \# DMERCA MC-B'S | PA |
| 05 | — | 100765534-0002 | — | PA |
| 01 | — | 100765534-0004 | 2ND PROMISE\# PA MEDICAID | PA |
| 01 | — | 5967 | BLUE CROSS PROVIDER\# | PA |