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NPI Code Detail

MEDICARE: ASBURY ATLANTIC, INC.

MEDICARE: ASBURY ATLANTIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility050802PA
23104A0630XAssisted Living Facility (Behavioral Disturbances)314470PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487643870
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASBURY ATLANTIC, INC.
Provider Business Mailing Address
First Line : 951 WASHINGTON AVE
Second Line : 925 S. LINCOLN AVENUE
City : TYRONE
State : PA
Zip : 16686-1426
Country : US
Telephone Number : 814-684-0320
Fax Number : 814-684-0902
Provider Business Practice Location Address
First Line : 951 WASHINGTON AVE
Second Line : 925 S. LINCOLN AVENUE
City : TYRONE
State : PA
Zip : 16686-1426
Country : US
Telephone Number : 814-684-0320
Fax Number : 814-684-0902
Authorized Official
Title or Position : HEALTH INFORMATION TECHNICIAN
Name : MRS. MYRA L. ISENBERG I
Credential : RHIT
Telephone Number : 814-684-0320
Provider Enumeration Date : 10/18/2005
Last Update Date : 09/11/2025

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1467743153 — MR. KENT LONG OTR/L
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1619261096 — JAMI KUKLA M.S., CCC-SLP/L
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1649662727 — ALYSEN ROSCIA M.S.,CCC-SLP/L
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