Provider Demographics
NPI:1114920386
Name:PETER BECKER COMMUNITY
Entity Type:Organization
Organization Name:PETER BECKER COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERSTER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA,MBA,CASPF
Authorized Official - Phone:215-256-9501
Mailing Address - Street 1:800 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-1032
Mailing Address - Country:US
Mailing Address - Phone:215-256-9501
Mailing Address - Fax:215-256-9768
Practice Address - Street 1:800 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-1032
Practice Address - Country:US
Practice Address - Phone:215-256-9501
Practice Address - Fax:215-256-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA160602314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006548550001Medicaid
PA395648Medicare ID - Type Unspecified