Provider Demographics
NPI:1720020399
Name:MCKERLEY HEALTH CARE CENTERS, INC.
Entity Type:Organization
Organization Name:MCKERLEY HEALTH CARE CENTERS, INC.
Other - Org Name:LAUREL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4045
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 1:480 DONALD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5945
Practice Address - Country:US
Practice Address - Phone:603-627-4147
Practice Address - Fax:603-627-6294
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
NH02292314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
904460OtherHARVARD PILGRIM
1098913OtherAETNA-HMO
30-5086OtherANTHEM
36762OtherCIGNA - NH - VENDOR #
NH44001427Medicaid
59490OtherCIGNA - NH
889916OtherMVP HEALTH PLAN
=========OtherMARTIN'S POINT
NH44001427Medicaid
30-5086OtherANTHEM
1098913OtherAETNA-HMO