Provider Demographics
NPI:1225188386
Name:BAKERS BAY ELDERLY ASSOCIATES
Entity Type:Organization
Organization Name:BAKERS BAY ELDERLY ASSOCIATES
Other - Org Name:HARBOR VIEW TOWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:215-824-4200
Mailing Address - Street 1:9503 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-3039
Mailing Address - Country:US
Mailing Address - Phone:215-824-4200
Mailing Address - Fax:215-824-2683
Practice Address - Street 1:9503 STATE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-3039
Practice Address - Country:US
Practice Address - Phone:215-824-4200
Practice Address - Fax:215-824-2683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2012-08-29
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-07-31
Provider Licenses
StateLicense IDTaxonomies
PA179150310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility