Organization · Type 2 NPI

Immaculate Mary Home

Skilled Nursing Facility · Philadelphia, PA

NPI number 1205810587 Active

Practice location

2990 Holme Ave
Philadelphia, PA 19136-1830

Fax (215) 331-9105

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	090902 (PA)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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NPI record

NPI: 1205810587
Entity type: Organization (Type 2)
Issued: Dec 1, 2005
Last updated: Jun 16, 2008
Status: Active
Subpart: Yes of Catholic Health Care Services

Other names

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Immaculate Mary Home · doing business as

Authorized official

Mr. Michael Czekner
Chief Financial Officer
(215) 368-0900

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1205810587

Immaculate Mary Home's National Provider Identifier is 1205810587, issued on Dec 1, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 16, 2008.