- Enrollment id
- O20240227003838
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1730957689
- Multiple npi flag
- N
- Ccn
- 395078
- Associate id
- 3274978465
- Organization name
- PINE VIEW HEALTHCARE LLC
- Doing business as name
- PINE VIEW HEALTHCARE AND REHABILITATION CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PINE VIEW HEALTHCARE AND REHABILITATION CENTER
- Address line 1
- 50 N MALIN RD
- City
- BROOMALL
- State
- PA
- Zip code
- 190081429