Provider Demographics
NPI:1528287125
Name:MANOR'S CORP
Entity type:Organization
Organization Name:MANOR'S CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GENOESE-FULMER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:717-397-5583
Mailing Address - Street 1:PO BOX 7001
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-7001
Mailing Address - Country:US
Mailing Address - Phone:717-397-5583
Mailing Address - Fax:717-397-5093
Practice Address - Street 1:1941 BENMAR DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4418
Practice Address - Country:US
Practice Address - Phone:717-397-5583
Practice Address - Fax:717-397-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA220902314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018957820001Medicaid
PA396084Medicare ID - Type Unspecified