Provider Demographics
NPI:1225017130
Name:RIDGE CREST INC
Entity Type:Organization
Organization Name:RIDGE CREST INC
Other - Org Name:RIDGE CREST NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:215-355-6288
Mailing Address - Street 1:106 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966
Mailing Address - Country:US
Mailing Address - Phone:215-355-6288
Mailing Address - Fax:215-355-8127
Practice Address - Street 1:1730 BUCK ROAD NORTH
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053
Practice Address - Country:US
Practice Address - Phone:215-355-3131
Practice Address - Fax:215-355-0481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAA06720310400000X
PA181102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23145OtherHEALTH PARTNERS/SR. PART.
PA1039755OtherKEYSTONE MERCY
PA86246OtherAETNA / US HEALTHCARE
PA1169850001OtherDMERC
PA0005766000OtherBLUE CROSS
PA0012017830001Medicaid
PA0120178301OtherAMERICHOICE
PA395156Medicare ID - Type Unspecified