Provider Demographics
NPI:1346751948
Name:PEACHTREE HEALTH GROUP, LLC.
Entity Type:Organization
Organization Name:PEACHTREE HEALTH GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-622-6496
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19404-0709
Mailing Address - Country:US
Mailing Address - Phone:484-681-4697
Mailing Address - Fax:
Practice Address - Street 1:26900 LEWES GEORGETOWN HWY
Practice Address - Street 2:
Practice Address - City:HARBESON
Practice Address - State:DE
Practice Address - Zip Code:19951-2855
Practice Address - Country:US
Practice Address - Phone:302-684-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility