Provider Demographics
NPI:1265474910
Name:ACTS RETIREMENT-LIFE COMMUNITIES INC
Entity Type:Organization
Organization Name:ACTS RETIREMENT-LIFE COMMUNITIES INC
Other - Org Name:GRANITE FARMS ESTATES WILLOWBROOKE COURT AT GRANITE FARMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-661-8330
Mailing Address - Street 1:420 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2711
Mailing Address - Country:US
Mailing Address - Phone:215-661-8330
Mailing Address - Fax:215-661-8316
Practice Address - Street 1:1343 W BALTIMORE PIKE
Practice Address - Street 2:GRANITE FARMS ESTATES
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5519
Practice Address - Country:US
Practice Address - Phone:610-358-3440
Practice Address - Fax:610-358-9660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA073602313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005897000OtherPERSONAL CHOICE
111679OtherAETNA US HEALTHCARE
47562OtherPARTNERS MEDICARE CHOICE
0005897000OtherBLUE CROSS
911028OtherKEYSTONE
0005897000OtherPERSONAL CHOICE
=========OtherHUMANA
0005897000OtherBLUE CROSS