Provider Demographics
NPI:1386604171
Name:BROADMEADOW INVESTMENT LLC
Entity type:Organization
Organization Name:BROADMEADOW INVESTMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-427-8181
Mailing Address - Street 1:150 ONIX DR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1885
Mailing Address - Country:US
Mailing Address - Phone:484-731-2500
Mailing Address - Fax:484-731-1234
Practice Address - Street 1:500 SOUTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-449-3400
Practice Address - Fax:302-449-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000038459Medicaid
DE085050Medicare Oscar/Certification