Healthcare Provider Details

I. General information

NPI: 1922590603
Provider Name (Legal Business Name): LITITZ REHABILITATION & NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S BROAD ST
LITITZ PA
17543-1808
US

IV. Provider business mailing address

125 S BROAD ST
LITITZ PA
17543-1808
US

V. Phone/Fax

Practice location:
  • Phone: 717-626-0211
  • Fax: 717-626-4441
Mailing address:
  • Phone: 717-626-0211
  • Fax: 717-626-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled 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: JONATHAN STRAUSS
Title or Position: MEMBER
Credential:
Phone: 201-214-8889