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Organization

ELM TERRACE GARDENS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT CLARK MCLAIN C.P.A. (VICE PRESIDENT AND CFO)
(215) 361-5664
Entity
Organization

Contact information

Practice address
660 N BROAD ST, LANSDALE, PA 19446-2361
(215) 361-5664
(215) 361-5670
Mailing address
660 N BROAD ST, LANSDALE, PA 19446-2361
(215) 361-5664
(215) 361-5670

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
A45280
PA
314000000X
Skilled Nursing Facility
310802
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005832000
BLUE CROSS/KEYSTONE PROV#
PA
05
10081441140003
PA
01
54338
AETNA PROVIDER #
PA
Enumeration date
10/02/2006
Last updated
09/11/2025
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