Willow Terrace

LBN: Willow Terrace
Willow Terrace is an health care organization with primary practice located at 1 Penn Blvd , Phila PA 19144-1476. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Willow Terrace can be contacted via phone (215) 456-6611, or through Russo, Samuel via phone (215) 456-6611.

Contact Information

Primary practice address
1 Penn Blvd Phila PA 19144-1476
Phone: (215) 456-6611
Fax: (215) 457-4304
Website:
Map and Directions
Authorized official contact:
Name: Russo, Samuel
Phone: (215) 456-6611

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 072102 Pennsylvania

Profile Details

NPI number 1235138587
LBN Legal business name Willow Terrace
DBA Doing business as
Authorized official Russo, Samuel
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2005
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235138587 NPPES
Pennsylvania MEDICAID 1007544140014

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