Organization
CENTENNIAL HEALTHCARE, LLC
Active
Other names
Centennial Healthcare and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLEV J GESTETNER (MANAGING MEMBER)
(215) 477-1170
Entity
Organization
Contact information
Practice address
4400 W GIRARD AVE, PHILADELPHIA, PA 19104-1002
(215) 477-1170
(215) 473-8290
Mailing address
4400 W GIRARD AVE, PHILADELPHIA, PA 19104-1002
(215) 477-1170
(215) 473-8290
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
193902
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
395950
MEDICARE PROVIDER NUMBER
PA
Enumeration date
12/09/2011
Last updated
12/09/2011
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