Provider Demographics
NPI:1932478377
Name:WOODBINE SENIOR LIVING
Entity Type:Organization
Organization Name:WOODBINE SENIOR LIVING
Other - Org Name:SPRING VILLAGE AT FLORAL VALE
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNERELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-497-3003
Mailing Address - Street 1:600 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4202
Mailing Address - Country:US
Mailing Address - Phone:215-497-3003
Mailing Address - Fax:215-497-9330
Practice Address - Street 1:600 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-4202
Practice Address - Country:US
Practice Address - Phone:215-497-3003
Practice Address - Fax:215-497-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)