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General NPI Number Information
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NPI Number | 1740287499
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Entity Type | Organization
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Legal Business Name | GUY AND MARY FELT MANOR, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 110 E 4TH ST
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City | EMPORIUM
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State | PA
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Zip | 15834-1445
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Country | US
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Telephone | 814-486-3736
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Fax | 814-486-3827
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Provider Business Mailing Address
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Address Line | 110 E 4TH ST
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City | EMPORIUM
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State | PA
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Zip | 15834-1445
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Country | US
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Telephone | 814-486-3736
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Fax | 814-486-3827
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KIMBERLY ANN JONES
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Credential | NHA
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Telephone | 814-486-3736
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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 | 75018441
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License Number State | PA
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