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NPI Code Detail

MEDICARE: LAFAYETTE MANOR, INC

MEDICARE: LAFAYETTE MANOR, 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
1310400000XAssisted Living Facility409610PA
2314000000XSkilled Nursing Facility120202PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10544OTHERPABLUECROSS PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508869652
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAFAYETTE MANOR, INC
Provider Business Mailing Address
First Line : 147 LAFAYETTE MANOR ROAD
Second Line :
City : UNIONTOWN
State : PA
Zip : 15401
Country : US
Telephone Number : 724-430-4848
Fax Number : 724-430-1881
Provider Business Practice Location Address
First Line : 147 LAFAYETTE MANOR ROAD
Second Line :
City : UNIONTOWN
State : PA
Zip : 15401-8900
Country : US
Telephone Number : 724-430-4848
Fax Number : 724-430-1881
Authorized Official
Title or Position : NURSING HOME ADMINISTRATOR
Name : MARY KETTERMAN
Credential : NHA
Telephone Number : 724-430-4848
Provider Enumeration Date : 05/23/2005
Last Update Date : 01/07/2025

Similar Medicare Providers

1346713831 — BRIAN D SCAIFE
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:
1205309705 — ERIN NICOLE BRADY
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:
1659844157 — ANITA LYNN SUTTON
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:
1528531035 — NIKITA NICKLOW PTA
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:
1053884486 — AMY COSTELLO OTR/L
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:
1518431550 — CARLEY JO SANTA COTA/L
Practice Location Address:
147 LAFAYETTE MANOR RD
UNIONTOWN, PA
15401-8900
Practice Phone: 724-430-4848
Practice Fax:

Directions to “LAFAYETTE MANOR, INC ” Practice Location

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