Provider Demographics
NPI:1043810880
Name:SH OPCO THE QUADRANGLE LLC
Entity Type:Organization
Organization Name:SH OPCO THE QUADRANGLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-642-3000
Mailing Address - Street 1:3300 DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1061
Mailing Address - Country:US
Mailing Address - Phone:610-642-3000
Mailing Address - Fax:610-642-5743
Practice Address - Street 1:3300 DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1061
Practice Address - Country:US
Practice Address - Phone:610-642-3000
Practice Address - Fax:610-642-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility