EDELLA STREET ASSOCIATES NPI 1104852987

NPI Information

  • NPI: 1104852987
  • Provider Name: EDELLA STREET ASSOCIATES
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: WILLOWBROOK ASSISTED LIVING COMMUNITY
  • CLIA Number: 39D2152840
  • Address: 150 EDELLA RD
    CLARKS SUMMIT, PA
    ZIP 18411
  • Phone: (570) 586-6028

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NPI Details

EDELLA STREET ASSOCIATES is an assisted living facility in Clarks Summit, PA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EDELLA STREET ASSOCIATES NPI is 1104852987. The provider is registered as an organization entity type.
The provider Is Doing Business As Willowbrook Assisted Living Community.

The provider's business location address is:

150 EDELLA RD
CLARKS SUMMIT, PA
ZIP 18411-628
Phone: (570) 586-6028
Fax: (570) 587-1338

The provider's authorized official is Jane Dropeskey .
The authorized official title is Corporate Manager and has the following contact phone number (610) 925-4231.

The CLIA number assigned to this NPI record is 39D2152840 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 11/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility243030PENNSYLVANIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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