Healthcare Provider Details

I. General information

NPI: 1457329294
Provider Name (Legal Business Name): MEADOWVIEW MANOR REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14330 CROGHAN PIKE
MOUNT UNION PA
17066
US

IV. Provider business mailing address

14330 CROGHAN PIKE
MOUNT UNION PA
17066
US

V. Phone/Fax

Practice location:
  • Phone: 814-542-8630
  • Fax: 814-542-2828
Mailing address:
  • Phone: 814-542-8630
  • Fax: 814-542-2828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BRANDI PARKES
Title or Position: CLINICAL SUPERVISOR
Credential:
Phone: 814-542-8630