Healthcare Provider Details

I. General information

NPI: 1063340008
Provider Name (Legal Business Name): JOHNSTOWN OPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3324 ELTON RD
JOHNSTOWN PA
15904-2991
US

IV. Provider business mailing address

5900 CLEARWATER DR STE 500
MINNETONKA MN
55343-8961
US

V. Phone/Fax

Practice location:
  • Phone: 814-266-7113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KATE RYG
Title or Position: MEDICAID SERVICES MANAGER
Credential:
Phone: 763-486-9187