Provider Demographics
NPI:1003523770
Name:IVY HILL POST ACUTE NURSING & REHABILITATION
Entity Type:Organization
Organization Name:IVY HILL POST ACUTE NURSING & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AVRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-233-5605
Mailing Address - Street 1:1401 IVY HILL RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1524
Mailing Address - Country:US
Mailing Address - Phone:215-233-5605
Mailing Address - Fax:
Practice Address - Street 1:1401 IVY HILL RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1524
Practice Address - Country:US
Practice Address - Phone:215-233-5605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
395525Other395525