Healthcare Provider Details

I. General information

NPI: 1841284098
Provider Name (Legal Business Name): PRESBYTERIAN HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 SYCAMORE RD
MONTOURSVILLE PA
17754-9519
US

IV. Provider business mailing address

1 TRINITY DR E SUITE 201
DILLSBURG PA
17019-8522
US

V. Phone/Fax

Practice location:
  • Phone: 570-326-2037
  • Fax: 717-737-6763
Mailing address:
  • Phone: 717-502-8840
  • Fax: 717-502-8843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number194402
License Number StatePA

VIII. Authorized Official

Name: MRS. DONNA B CASNER
Title or Position: VP/CONTROLLER
Credential:
Phone: 717-502-8922