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General NPI Number Information
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NPI Number | 1992756225
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Entity Type | Organization
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Legal Business Name | GGNSC EAST STROUDSBURG LP
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 221 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3005
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Country | US
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Telephone | 570-421-6200
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Fax | 570-421-6718
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Provider Business Mailing Address
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Address Line | 221 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3005
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Country | US
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Telephone | 570-421-6200
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Fax | 570-421-6718
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Authorized Official
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Title or Position | SEC. OF THE GP
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Name | HOLLY A. RASMUSSEN-JONES
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Credential |
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Telephone | 479-201-4835
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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 | 194002
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License Number State | PA
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