Healthcare Provider Details

I. General information

NPI: 1841022548
Provider Name (Legal Business Name): SCOTTDALE PA OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PORTER AVE
SCOTTDALE PA
15683-1147
US

IV. Provider business mailing address

900 PORTER AVE
SCOTTDALE PA
15683-1147
US

V. Phone/Fax

Practice location:
  • Phone: 724-887-0100
  • Fax:
Mailing address:
  • Phone: 724-887-0100
  • 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: MR. ARIEL LEV
Title or Position: OPERATOR
Credential:
Phone: 845-521-0490