Organization · NPI-2
1
Skilled Nursing Facility, Nursing Care, Pediatric · Mountain Top, PA
NPI number1104246222
StatusActive
Last updated in NPPESApr 16, 2014
Details
- NPI
- 1104246222
- Entity type
- Organization (NPI-2)
- Legal business name
- 1
- Organization subpart
- No
- Enumeration date
- Apr 16, 2014
- Last updated
- Apr 16, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3140N1450X | Skilled Nursing Facility, Nursing Care, Pediatric | RN586725 | PA | Yes |
Practice location
14 Basswood DrMountain Top, PA 18707-1824
Phone 570-474-0859
Mailing address
14 Basswood DrMountain Top, PA 18707-1824
Phone 570-474-0859
Authorized official
Valerie Jane Weigand
Rn
5704740859
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