- Enrollment id
- O20141114001409
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1710395009
- Multiple npi flag
- N
- Ccn
- 395815
- Associate id
- 1153543723
- Organization name
- 470 MANOR OPERATING LLC
- Doing business as name
- ST. MARTHA CENTER FOR REHABILITATION & HEALTHCARE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ST MARTHA CENTER FOR REHABILITATION & HEALTHCARE
- Affiliation entity name
- CENTER MANAGEMENT GROUP
- Affiliation entity id
- 619
- Address line 1
- 470 MANOR AVENUE
- City
- DOWNINGTOWN
- State
- PA
- Zip code
- 193352545