Healthcare Provider Details

I. General information

NPI: 1831189968
Provider Name (Legal Business Name): CENTRAL PENNSYLVANIA NURSING ALLIANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 OAK ST
AKRON PA
17501-1489
US

IV. Provider business mailing address

604 OAK ST
AKRON PA
17501-1489
US

V. Phone/Fax

Practice location:
  • Phone: 717-859-1191
  • Fax: 717-859-4873
Mailing address:
  • Phone: 717-859-1191
  • Fax: 717-859-4873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number390702
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0016657370002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MRS. RACHEL M ZELLERS
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 717-859-1191