Healthcare Provider Details

I. General information

NPI: 1659875789
Provider Name (Legal Business Name): GUARDIAN ELDER CARE AT MUNHALL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W RUN RD
MUNHALL PA
15120-2869
US

IV. Provider business mailing address

8796 ROUTE 219
BROCKWAY PA
15824-6010
US

V. Phone/Fax

Practice location:
  • Phone: 412-462-8002
  • 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: ARMANDO FORTUNATO
Title or Position: CFO
Credential:
Phone: 814-265-1164