Provider Demographics
NPI:1801032420
Name:SENIOR CARE CENTERS OF PENNSYLVANIA
Entity Type:Organization
Organization Name:SENIOR CARE CENTERS OF PENNSYLVANIA
Other - Org Name:ACTIVE DAY OF CROZER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCKENBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-642-6600
Mailing Address - Street 1:6 NESHAMINY INTERPLEX
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6964
Mailing Address - Country:US
Mailing Address - Phone:215-642-6600
Mailing Address - Fax:215-642-6610
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:SILBERMAN BUILDING
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-447-2935
Practice Address - Fax:610-447-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA304220261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007616510015Medicaid