Healthcare Provider Details

I. General information

NPI: 1659369817
Provider Name (Legal Business Name): OVERLOOK LEASING PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 EVERGREEN MILL RD
HARMONY PA
16037-9141
US

IV. Provider business mailing address

191 EVERGREEN MILL RD
HARMONY PA
16037-9141
US

V. Phone/Fax

Practice location:
  • Phone: 724-452-6970
  • Fax: 724-452-1333
Mailing address:
  • Phone: 724-452-6970
  • Fax: 724-452-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number051302
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1007300740005
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MR. FRANCIS A HAYMAN JR.
Title or Position: PRESIDENT LEHIGH NURSING CORP
Credential:
Phone: 610-264-8000