Provider Demographics
NPI:1639176977
Name:BRIARLEAF NURSING AND CONVALESCENT, INC.
Entity Type:Organization
Organization Name:BRIARLEAF NURSING AND CONVALESCENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:MULROY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:610-630-2400
Mailing Address - Street 1:252 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4459
Mailing Address - Country:US
Mailing Address - Phone:215-348-2983
Mailing Address - Fax:215-340-1308
Practice Address - Street 1:252 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4459
Practice Address - Country:US
Practice Address - Phone:215-348-2983
Practice Address - Fax:215-340-1308
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCORD HEALTH SERVICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA331402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA27830OtherUS HEALTHCARE
PW0007908660002Medicaid
PA005931OtherKEYSTONE HMO
PA5931OtherIBC
PA1073452OtherKEYSTONE MERCY
PA39-5409Medicare ID - Type UnspecifiedMEDICARE