Provider Demographics
NPI:1841299880
Name:UNITARIAN UNIVERSALIST HOUSE OF THE JOSEPH PRIESTLEY DISTRICT
Entity type:Organization
Organization Name:UNITARIAN UNIVERSALIST HOUSE OF THE JOSEPH PRIESTLEY DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TARABORRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-843-0809
Mailing Address - Street 1:224 W TULPEHOCKEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3210
Mailing Address - Country:US
Mailing Address - Phone:215-843-0809
Mailing Address - Fax:215-842-9215
Practice Address - Street 1:224 W TULPEHOCKEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3210
Practice Address - Country:US
Practice Address - Phone:215-843-0809
Practice Address - Fax:215-842-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA210202314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006168000OtherINDEPENDENCE BLUE CROSS
PA0007573240001Medicaid
PA395980Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER