Provider Demographics
NPI:1629010368
Name:MCKERLEY HEALTH CARE CENTERS, INC.
Entity Type:Organization
Organization Name:MCKERLEY HEALTH CARE CENTERS, INC.
Other - Org Name:LACONIA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:175 BLUEBERRY LN
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2918
Practice Address - Country:US
Practice Address - Phone:603-524-3340
Practice Address - Fax:603-524-7049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02297314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
41330OtherCIGNA-NH
NH80305015Medicaid
904458OtherHARVARD PILGRIM
1038955OtherAETNA-HMO
889918OtherMVP HEALTH PLAN
36760OtherCIGNA-NH - VENDOR #
30-5040OtherANTHEM
=========OtherMARTIN'S POINT
30-5040OtherANTHEM
NH80305015Medicaid
=========OtherAETNA-NONHMO