Healthcare Provider Details

I. General information

NPI: 1144903865
Provider Name (Legal Business Name): GREENVILLE REHABILITATION & NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FREDONIA RD
GREENVILLE PA
16125-7911
US

IV. Provider business mailing address

110 FREDONIA RD
GREENVILLE PA
16125-7911
US

V. Phone/Fax

Practice location:
  • Phone: 724-588-8090
  • Fax:
Mailing address:
  • Phone: 724-588-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN STRAUSS
Title or Position: MEMBER
Credential:
Phone: 917-881-9402