OrganizationActive
Evangelical Manor
NPI 1043207152 · Skilled Nursing Facility · Philadelphia, PA
Provider details
- NPI number
- 1043207152
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Ronnie Conner, Corporate Director of Rcm(267) 885-6232
- License
- 311202 (PA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8401 Roosevelt Blvd
Philadelphia, PA 19152-2034
Phone: (215) 624-5800
Fax: (215) 335-1477
Street-level locationGet directions
Mailing address
8401 Roosevelt Blvd
Philadelphia, PA 19152-2034
Other names (DBA / former)
- Doing business as
- Wesley Enhanced Living at Pennypack Park
Registry dates
- Enumerated
- 2005-10-04
- Last updated
- 2026-05-28
- Certified
- 2026-05-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.