Provider Demographics
NPI:1306830625
Name:PRESBYTERIAN HOMES INC.
Entity Type:Organization
Organization Name:PRESBYTERIAN HOMES INC.
Other - Org Name:WESTMINSTER VILLAGE DOVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CASNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-502-8922
Mailing Address - Street 1:1 TRINITY DR E
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-8522
Mailing Address - Country:US
Mailing Address - Phone:717-502-8595
Mailing Address - Fax:717-502-8842
Practice Address - Street 1:1175 MCKEE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2268
Practice Address - Country:US
Practice Address - Phone:717-502-8595
Practice Address - Fax:717-502-8840
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-01
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE00225314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000122612Medicaid
DE0000124611Medicaid
DE085032Medicare ID - Type UnspecifiedWESTMINSTER VILLAGE DOVER