Provider Demographics
NPI:1619603990
Name:ENLIVE OPERATOR LLC
Entity Type:Organization
Organization Name:ENLIVE OPERATOR LLC
Other - Org Name:ENLIVE REHABILITATION AND WELLNESS AT INGLIS HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICARE ADMINISTRATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MINDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-825-2217
Mailing Address - Street 1:2600 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2713
Practice Address - Country:US
Practice Address - Phone:215-878-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility