Healthcare Provider Details

I. General information

NPI: 1982203899
Provider Name (Legal Business Name): SENA KEAN SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17083 ROUTE 6
SMETHPORT PA
16749-4025
US

IV. Provider business mailing address

17083 ROUTE 6
SMETHPORT PA
16749-4025
US

V. Phone/Fax

Practice location:
  • Phone: 814-887-5601
  • Fax: 814-887-2085
Mailing address:
  • Phone: 814-887-5601
  • Fax: 814-887-2085

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: MR. CHAIM STEG
Title or Position: OWNER
Credential:
Phone: 732-267-9679