NPI Provider: 1033114707
Contact Name: Subers M. Michele
Position: CFO
Phone: (610) 658-5122
Old Man’s Home Information:
Old Man’s Home organization have npi 1033114707, taxonomy code is 314000000X with license number is 190402 in . This Business address located in 100 E Lancaster Ave, Wynnewood, PA 19096 Pennsylvania.
Practice Location
Address: 100 E Lancaster Ave, Wynnewood, PA 19096
Phone: (610) 658-5100
Business Location
Address: 100 E Lancaster Ave, Wynnewood, PA 19096
Phone: (610) 658-5100
Fax: (610) 795-5000
Taxonomy
Taxonomy Code: 314000000X
License Number: 190402
License Number of State: PA
Primary Taxonomy Switch: Y
Enumeration Date: 6/17/2005
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