- Enrollment id
- O20211021002786
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1215518949
- Multiple npi flag
- N
- Ccn
- 395791
- Associate id
- 8729488523
- Organization name
- COMPLETE CARE AT HARSTON HALL LLC
- Incorporation date
- 2021-01-20
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COMPLETE CARE AT HARSTON HALL LLC
- Affiliation entity name
- COMPLETE CARE
- Affiliation entity id
- 157
- Address line 1
- 350 HAWS LANE
- City
- FLOURTOWN
- State
- PA
- Zip code
- 190312100