Provider Demographics
NPI:1720020290
Name:MCKERLEY HEALTH CARE CENTERS INC.
Entity Type:Organization
Organization Name:MCKERLEY HEALTH CARE CENTERS INC.
Other - Org Name:LEBANON CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
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 1:24 OLD ETNA RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1937
Practice Address - Country:US
Practice Address - Phone:603-448-2234
Practice Address - Fax:603-448-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02289314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
30-5050OtherANTHEM
NH30002722Medicaid
903354OtherHARVARD PILGRIM
VT305050Medicaid
365167OtherCIGNA - NH
889915OtherMVP HEALTH PLAN
1038917OtherAETNA-HMO
36766OtherCIGNA - NH - VENDOR #
1038917OtherAETNA-HMO
30-5050OtherANTHEM
889915OtherMVP HEALTH PLAN
=========OtherAETNA-NONHMO