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General NPI Number Information
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NPI Number | 1205841632
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Entity Type | Organization
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Legal Business Name | PENN VILLAGE FACILITY OPERATIONS, LLC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 51 ROUTE 204
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City | SELINSGROVE
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State | PA
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Zip | 17870-8066
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Country | US
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Telephone | 570-374-8181
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Fax | 570-372-2398
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Provider Business Mailing Address
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Address Line | 51 ROUTE 204
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City | SELINSGROVE
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State | PA
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Zip | 17870-8066
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Country | US
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Telephone | 570-374-8181
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Fax | 570-372-2398
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Authorized Official
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Title or Position | MANAGER
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Name | TIFFANY HOBACK
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Credential |
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Telephone | 770-698-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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