Organization Active NPI

Northeast SNF Operations

  • Skilled Nursing Facility
  • Bryn Mawr, PA
National Provider Identifier
1124608187
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
NORTHEAST SNF OPERATIONS
Practice address
773 E Haverford
Bryn Mawr, PA 19010
Phone
(610) 525-8300
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Light
Title
Chief Executive
Phone
(917) 797-3669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

773 E Haverford
Bryn Mawr, PA 19010

Mailing address

773 E Haverford
Bryn Mawr, PA 19010
Phone (610) 525-8300

Other names 1

  • Bryn Mawr Village Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211122000780 PA Part A Provider - Skilled Nursing Facility 7214326818 Practice locations: Bryn Mawr, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124608187. Details of each certification follow.

Skilled nursing facility certification: CCN 395095

Legal name
NORTHEAST SNF OPERATIONS LLC
Doing business as
BRYN MAWR VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 1, 1967
Last certification
Mar 6, 2025
Beds
120
Ownership / control type
Nonprofit Corporation
Organization structure
LLCProprietary
Incorporated
Mar 10, 2021 in PA
Enrollment address
773 E Haverford Road
Bryn Mawr, PA 19010-3837
Nursing home name
BRYN MAWR VILLAGE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bryn Mawr VillageCCN 395095 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12033.7 residents per day on average
Penalties (3 years)
1Fines totaling $15,902

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2297381Bryn Mawr Village773 East Haverford Rd, Bryn Mawr, PA 19010Certificate of waiverJan 15, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Compassionate Care Healthcare Consultants LLC Organization, Valley Stream, NY LLC, Management services company Operational/Managerial Control Aug 30, 2021 100%
Cory Wake Individual Corporate DirectorDirector/Board of Directors,Pres Aug 30, 2021 100%
Akiko Ike Individual Corporate DirectorDirector/Board of Directors Aug 30, 2021 100%
Haverford Holding Company Inc Organization, Ann Arbor, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 30, 2021 100%
John Fredericks Individual W-2 Managing EmployeeAdministrator Aug 30, 2021 100%
Miriam Braunstein Individual Corporate DirectorDirector/Board of Directors Aug 30, 2021 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1124608187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 E HAVERFORD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "19010",
            "telephone_number": "610-525-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 E HAVERFORD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "19010",
            "telephone_number": "610-525-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SNF OPERATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE",
        "authorized_official_telephone_number": "917-797-3669"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryn Mawr Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.