- Enrollment id
- O20030612000021
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1376530469
- Multiple npi flag
- N
- Ccn
- 395134
- Associate id
- 7810807021
- Organization name
- INGLIS HOUSE
- Incorporation date
- 1877-11-14
- Incorporation state
- PA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- INGLIS HOUSE
- Address line 1
- 2600 BELMONT AVE
- City
- PHILADELPHIA
- State
- PA
- Zip code
- 191312713