MEDICARE: ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	10502	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0635	OTHER	PA	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265435952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.

Provider Business Mailing Address
First Line	:	916 HICKORY ST
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-2248
Country	:	US
Telephone Number	:	814-696-4500
Fax Number	:	814-696-4561

Provider Business Practice Location Address
First Line	:	915 HICKORY ST
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-2247
Country	:	US
Telephone Number	:	814-696-4500
Fax Number	:	814-696-4561

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MS. PATRICIA SAVAGE
Credential	:	PHD, NHA
Telephone Number	:	814-696-4518

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	04/20/2008

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