Organization
COUNTY OF LEHIGH PENNSYLVANIA
Active
Parent organization
LEHIGH CO CHIEF EX OFF
Other names
CEDARBROOK LEHIGH CO HOMES
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEHIGH CO CHIEF EX OFF
Authorized official
MR. JOSEPH SHADID RN, MSN, MBS, NHA (DIRECTOR/ADMINISTRATOR)
(610) 395-3727
Entity
Organization
Contact information
Practice address
350 S CEDARBROOK RD, ALLENTOWN, PA 18104-5708
(610) 395-3727
(610) 395-4737
Mailing address
350 S CEDARBROOK RD, ALLENTOWN, PA 18104-5708
(610) 395-3727
(610) 395-4737
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
550102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005757700002
—
PA
05
—
0005757700003
—
PA
05
—
1000072380063
—
PA
05
—
1000072380064
—
PA
01
—
1648
BLUE SHIELD
PA
01
—
A08008670
MEDICARE DMERC
PA
Enumeration date
06/16/2005
Last updated
12/07/2016
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