- Enrollment id
- O20230310002376
- Enrollment state
- PA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952029126
- Multiple npi flag
- N
- Ccn
- 395847
- Associate id
- 8224401302
- Organization name
- MONTGOMERY SNF OPERATOR LLC
- Doing business as name
- MONTGOMERY SUBACUTE AND RESPIRATORY CENTER
- Incorporation date
- 2022-08-09
- Incorporation state
- PA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- MONTGOMERY SUBACUTE AND RESPIRATORY CENTER
- Affiliation entity name
- MARQUIS HEALTH SERVICES
- Affiliation entity id
- 336
- Address line 1
- 251 STENTON AVE
- City
- PLYMOUTH MEETING
- State
- PA
- Zip code
- 194621246