Provider Demographics
NPI:1063458198
Name:MCKERLEY HEALTH CARE CENTERS, INC.
Entity Type:Organization
Organization Name:MCKERLEY HEALTH CARE CENTERS, INC.
Other - Org Name:RIDGEWOOD CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:25 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6510
Practice Address - Country:US
Practice Address - Phone:603-623-8805
Practice Address - Fax:603-647-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02294314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
903352OtherHARVARD PILGRIM
889912OtherMVP HEALTH PLAN
36765OtherCIGNA-NH - VENDOR #
1038665OtherAETNA-HMO
365160OtherCIGNA-NH
30-5052OtherANTHEM
NH40305034Medicaid
=========OtherAETNA-HMO
=========OtherHNFS-TRICARE
30-5052OtherANTHEM
=========OtherGREAT-WEST HEALTHCARE