Provider Demographics
NPI:1598922858
Name:STABON MANOR PCH, INC
Entity Type:Organization
Organization Name:STABON MANOR PCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PILAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-373-2272
Mailing Address - Street 1:1555 HAAK ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-2212
Mailing Address - Country:US
Mailing Address - Phone:610-373-2272
Mailing Address - Fax:
Practice Address - Street 1:1555 HAAK ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-2212
Practice Address - Country:US
Practice Address - Phone:610-373-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2051203104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness