Provider Demographics
NPI:1457392235
Name:CRESTVIEW CONVALESCENT HOME, INC.
Entity type:Organization
Organization Name:CRESTVIEW CONVALESCENT HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:1245 CHURCH RD
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1800
Practice Address - Country:US
Practice Address - Phone:215-884-9990
Practice Address - Fax:215-884-5579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA034402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005831000OtherIBC
116OtherELDER HEALTH
0005831000OtherAMERIHEALTH
1046877OtherKEYSTONE MERCY
20678OtherHEALTH PARTNERS
255069OtherHEALTH AMERICA
PA1007737790001Medicaid
317144OtherUS FAMILY HEALTH PLAN
IY0229OtherHEALTHNET OF PA
13144OtherAETNA-HMO
255069OtherHEALTH AMERICA
=========OtherCIGNA-PA
0005831000OtherAMERIHEALTH
20678OtherHEALTH PARTNERS
IY0229OtherHEALTHNET OF PA