Healthcare Provider Details
I. General information
NPI: 1861034266
Provider Name (Legal Business Name): JEFFERSON HILLS REHABILITATION AND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2019
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US
IV. Provider business mailing address
540 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3704
US
V. Phone/Fax
- Phone: 412-466-1125
- Fax:
- Phone: 412-466-1125
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
DAVE
FERRARO
Title or Position: ADMINISTRATOR
Credential:
Phone: 412-466-1125