- Enrollment id
- O20050909000137
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1922056076
- Multiple npi flag
- N
- Ccn
- 396101
- Associate id
- 9032141189
- Organization name
- SHANNONDELL, INC.
- Doing business as name
- REHAB AT SHANNONDELL
- Incorporation date
- 1999-02-04
- Incorporation state
- PA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- REHAB AT SHANNONDELL
- Address line 1
- 5000 SHANNONDELL DR
- City
- AUDUBON
- State
- PA
- Zip code
- 194035684