Provider Demographics
NPI:1255312138
Name:KENDAL-CROSSLANDS COMMUNITIES
Entity Type:Organization
Organization Name:KENDAL-CROSSLANDS COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
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 2:1660 EAST STREET ROAD
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-0100
Mailing Address - Country:US
Mailing Address - Phone:610-388-5500
Mailing Address - Fax:484-259-0200
Practice Address - Street 1:1660 EAST STREET RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-0100
Practice Address - Country:US
Practice Address - Phone:610-388-5500
Practice Address - Fax:484-259-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA173938Medicare ID - Type Unspecified