Provider Demographics
NPI:1609167154
Name:KEARSLEY OPERATOR LP
Entity Type:Organization
Organization Name:KEARSLEY OPERATOR LP
Other - Org Name:KEARSLEY LONG TERM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YONAH
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-415-6022
Mailing Address - Street 1:575 ROUTE 70 FL 2
Mailing Address - Street 2:P.O. BOX 1030
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4042
Mailing Address - Country:US
Mailing Address - Phone:732-415-6022
Mailing Address - Fax:732-415-2007
Practice Address - Street 1:2100 NORTH 49TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2698
Practice Address - Country:US
Practice Address - Phone:215-877-1565
Practice Address - Fax:215-877-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility