Provider Demographics
NPI:1124023148
Name:COMMUNITY WELFARE COUNCIL OF NEWTOWN
Entity Type:Organization
Organization Name:COMMUNITY WELFARE COUNCIL OF NEWTOWN
Other - Org Name:PICKERING MANOR HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-968-3878
Mailing Address - Street 1:226 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2216
Mailing Address - Country:US
Mailing Address - Phone:215-968-3878
Mailing Address - Fax:215-968-8894
Practice Address - Street 1:226 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2216
Practice Address - Country:US
Practice Address - Phone:215-968-3878
Practice Address - Fax:215-968-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA160802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007507710002Medicaid
PA395597Medicare ID - Type Unspecified