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General NPI Number Information
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NPI Number | 1942283528
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Entity Type | Organization
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Legal Business Name | COUNTY OF INDIANA
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 1675 SALTSBURG AVE
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City | INDIANA
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State | PA
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Zip | 15701-3573
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Country | US
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Telephone | 724-465-3900
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Fax | 724-465-2013
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Provider Business Mailing Address
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Address Line | 1675 SALTSBURG AVE
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City | INDIANA
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State | PA
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Zip | 15701-3573
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Country | US
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Telephone | 724-465-3900
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Fax | 724-465-2013
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KIMBERLY COBAUGH
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Credential | RNC, MSN, NHA
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Telephone | 724-465-3900
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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 | 090102
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License Number State | PA
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