Provider Demographics
NPI:1063830487
Name:CH-WYOMISSING LLC
Entity Type:Organization
Organization Name:CH-WYOMISSING LLC
Other - Org Name:WYOMISSING HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-801-7600
Mailing Address - Street 1:1000 E WYOMISSING BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1764
Mailing Address - Country:US
Mailing Address - Phone:610-376-3991
Mailing Address - Fax:
Practice Address - Street 1:1000 E WYOMISSING BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1764
Practice Address - Country:US
Practice Address - Phone:610-376-3991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHESTNUT HEALTH AND REHABILITATION GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA232202314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395237Medicare Oscar/Certification