Healthcare Provider Details

I. General information

NPI: 1497746713
Provider Name (Legal Business Name): UNITED CHURCH OF CHRIST HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 E MAIN ST
ANNVILLE PA
17003-1511
US

IV. Provider business mailing address

550 E MAIN ST
ANNVILLE PA
17003-1511
US

V. Phone/Fax

Practice location:
  • Phone: 717-867-4467
  • Fax: 717-867-7060
Mailing address:
  • Phone: 717-867-4467
  • Fax: 717-867-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number730602
License Number StatePA

VIII. Authorized Official

Name: MR. STEPHEN HORVATH
Title or Position: EXECUTIVE DIRECTOR CHIEF EXECUTIVE
Credential:
Phone: 717-303-1502