Organization
115 S PROVIDENCE ROAD OPERATIONS LLC
Active
Parent organization
GENESIS PM PA OPERATIONS LLC
Other names
WALLINGFORD BOROUGH SKILLED NURSING AND REHABILITATION CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS PM PA OPERATIONS LLC
Authorized official
MICHAEL T BERG (SECRETARY)
(505) 468-4742
Entity
Organization
Contact information
Practice address
115 S PROVIDENCE RD, WALLINGFORD, PA 19086-6333
(610) 444-6350
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 612-5327
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
06/23/2025
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