Provider Demographics
NPI:1659377034
Name:TEL HAI RETIREMENT COMMUNITY
Entity Type:Organization
Organization Name:TEL HAI RETIREMENT COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP OF FINANCE & ADMINISTRATI
Authorized Official - Prefix:MRS
Authorized Official - First Name:M SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDEGEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-273-9333
Mailing Address - Street 1:1200 TEL HAI CIR
Mailing Address - Street 2:P O BOX 190
Mailing Address - City:HONEY BROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19344-1271
Mailing Address - Country:US
Mailing Address - Phone:610-273-9333
Mailing Address - Fax:610-273-4141
Practice Address - Street 1:1200 TEL HAI CIR
Practice Address - Street 2:
Practice Address - City:HONEY BROOK
Practice Address - State:PA
Practice Address - Zip Code:19344-1271
Practice Address - Country:US
Practice Address - Phone:610-273-9333
Practice Address - Fax:610-273-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA200102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008752500001Medicaid
PA1008752500001Medicaid