Provider Demographics
NPI:1346249646
Name:HIGHLAND MANOR ASSOCIATES
Entity Type:Organization
Organization Name:HIGHLAND MANOR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:LENARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-663-4044
Mailing Address - Street 1:750 SCHOOLEY AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-9380
Mailing Address - Country:US
Mailing Address - Phone:570-655-3791
Mailing Address - Fax:856-665-5708
Practice Address - Street 1:1114 WYNNWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3256
Practice Address - Country:US
Practice Address - Phone:856-663-4044
Practice Address - Fax:856-665-5708
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIORS MANAGEMENT NORTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-19
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA340902314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395566Medicare Oscar/Certification
PA395566Medicare ID - Type Unspecified
PA0479160001Medicare NSC