IMMACULATE MARY HOME
NPI 1205810587
Skilled Nursing Facility in Philadelphia, PA
About Immaculate Mary Home NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IMMACULATE MARY HOME (NPI 1205810587) is a healthcare organization registered as a skilled nursing facility in Philadelphia, Pennsylvania and active in the NPI registry since December 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Michael Czekner, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 39D0202602
Immaculate Mary Home · Philadelphia, PAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19136
PHILADELPHIA, PA 19136
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Immaculate Mary Home's NPI number?
The NPI number for Immaculate Mary Home is 1205810587. It was assigned to this organization in the NPPES registry on December 1, 2005.
Where is Immaculate Mary Home located?
Immaculate Mary Home is located at 2990 Holme Ave, Philadelphia, PA 19136. The listed phone number is (215) 335-2100.
What is Immaculate Mary Home's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Does Immaculate Mary Home hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 39D0202602) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Immaculate Mary Home was last updated on June 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.