Healthcare Provider Details

I. General information

NPI: 1851225676
Provider Name (Legal Business Name): CEDAR HAVEN HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 S 5TH AVE
LEBANON PA
17042-9195
US

IV. Provider business mailing address

590 S 5TH AVE
LEBANON PA
17042-9195
US

V. Phone/Fax

Practice location:
  • Phone: 717-274-0421
  • Fax:
Mailing address:
  • Phone:
  • 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: JOSEPH GLATZER
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 848-757-0550