Healthcare Provider Details

I. General information

NPI: 1174529069
Provider Name (Legal Business Name): UNITED ZION RETIREMENT COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 FURNACE HILLS PIKE
LITITZ PA
17543-7954
US

IV. Provider business mailing address

722 FURNACE HILLS PIKE
LITITZ PA
17543-7954
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-2071
  • Fax: 717-626-0911
Mailing address:
  • Phone: 717-626-2071
  • Fax: 717-626-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number470402
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier0007488530001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MRS. M. SUE VERDEGEM
Title or Position: PRESIDENT AND CEO
Credential: NHA, MBA
Phone: 717-626-2071