Provider Demographics
NPI:1174504062
Name:KENDAL-CROSSLANDS COMMUNITIES
Entity Type:Organization
Organization Name:KENDAL-CROSSLANDS COMMUNITIES
Other - Org Name:CROSSLANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-388-5666
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-0100
Mailing Address - Country:US
Mailing Address - Phone:610-388-5608
Mailing Address - Fax:610-388-5691
Practice Address - Street 1:1660 E STREET RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-2028
Practice Address - Country:US
Practice Address - Phone:610-388-5600
Practice Address - Fax:610-388-5691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395388Medicare ID - Type Unspecified