Healthcare Provider Details

I. General information

NPI: 1548602964
Provider Name (Legal Business Name): CENTRE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E HOWARD ST
BELLEFONTE PA
16823-2128
US

IV. Provider business mailing address

502 E HOWARD ST
BELLEFONTE PA
16823-2128
US

V. Phone/Fax

Practice location:
  • Phone: 814-355-6777
  • Fax:
Mailing address:
  • Phone: 814-355-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. CARL RAUP
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 814-693-3354