Provider Demographics
NPI:1235183237
Name:PROVIDENCE HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PROVIDENCE HEALTH CARE, INC.
Other - Org Name:BEL-AIRE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:35 BEL AIRE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-4953
Practice Address - Country:US
Practice Address - Phone:802-334-2878
Practice Address - Fax:802-334-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
317770OtherMVP HEALTH PLAN
VT0475049Medicaid
2462064OtherAETNA-HMO
VT0475049Medicaid
=========OtherMARTIAN'S POINT
2462064OtherAETNA-HMO
317770OtherMVP HEALTH PLAN
=========OtherHNFS-TRICARE