Rest Haven Nursing Center-Chestnut Hill-Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

700102 Issued in PA

Legal business name

REST HAVEN NURSING CENTER-CHESTNUT HILL-INC

Doing business as

Chestnut Hill Lodge Health and Rehabilitation Center

Practice address

8833 Stenton Avenue
Wyndmoor, PA 19038

Phone

(215) 836-2100

Fax

(215) 233-3551

NPI assigned

Dec 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Brian Reynolds

Title

Ceo

Phone

(410) 513-8738

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chestnut Hill Lodge Health and Rehabilitation Center Doing business as

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Pharmacy Corporation of America

  • Long Term Care Pharmacy
  • Rapid City, SD
  • NPI 1174556757

  Member Of

  NPD member
• Pharmerica Long-Term Care LLC

  • Long Term Care Pharmacy
  • El Paso, TX
  • NPI 1073546651

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1396720520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8833 STENTON AVENUE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "19038",
            "telephone_number": "215-836-2100",
            "fax_number": "215-233-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8833 STENTON AVENUE",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "19038",
            "telephone_number": "215-836-2100",
            "fax_number": "215-233-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REST HAVEN NURSING CENTER-CHESTNUT HILL-INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-513-8738",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "700102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007720920004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Hill Lodge Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Joseph Peterson, MD
• Allison Fox Powers
• Daila Melita Pravs, M.D.
• Jillian Prinz
• Christopher Matthew Raison, DPT
• Anthony Roselli, M.D.
• Maria Roth, PTA
• Scott Rubin, LSW
• Heather Ruthrauff, MS, OTR/L
• Neil L Sand, DO

• Skilled Nursing Facility in Wyndmoor, PA
• Providers in Wyndmoor, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.