Provider Demographics
NPI:1457419509
Name:HUMANGOOD PENNSYLVANIA
Entity Type:Organization
Organization Name:HUMANGOOD PENNSYLVANIA
Other - Org Name:SPRING MILL PRESBYTERIAN VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-260-1135
Mailing Address - Street 1:2000 JOSHUA RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2430
Mailing Address - Country:US
Mailing Address - Phone:610-260-1125
Mailing Address - Fax:610-260-0931
Practice Address - Street 1:2002 JOSHUA RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2430
Practice Address - Country:US
Practice Address - Phone:610-828-4848
Practice Address - Fax:610-828-4864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMANGOOD PENNSYLVANIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-04
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAA93040310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA284878OtherOCCUPANCY PERMIT #