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NPI Code Detail

MEDICARE: LUTHERAN HOME AT KANE PENNSYLVANIA

MEDICARE: LUTHERAN HOME AT KANE PENNSYLVANIA
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
1314000000XSkilled Nursing Facility902802PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130015545OTHERPAAMERIHEALTH MERCY HEALTH PLAN
2000065056XOTHERPAHUMANA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41217OTHERPAHIGHMARK
51603554OTHERPAGATEWAY HEALTH PLAN
6729732OTHERPAUPMC

General Provider Information

NPI Number : 1457355091
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN HOME AT KANE PENNSYLVANIA
Provider Business Mailing Address
First Line : 100 HIGH POINT DRIVE
Second Line :
City : KANE
State : PA
Zip : 16735-9704
Country : US
Telephone Number : 814-837-6706
Fax Number : 814-837-1051
Provider Business Practice Location Address
First Line : 100 HIGH POINT DRIVE
Second Line :
City : KANE
State : PA
Zip : 16735-9704
Country : US
Telephone Number : 814-837-6706
Fax Number : 814-837-1051
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MEGAN M BOLDEN
Credential : N.H.A.
Telephone Number : 814-837-6706
Provider Enumeration Date : 06/10/2005
Last Update Date : 12/29/2014

Similar Medicare Providers

1922122787 — MS. JERE AGNES EDEL SLP
Practice Location Address:
100 HIGH POINT DR
KANE, PA
16735-9704
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Practice Fax: 814-837-9205
1043336449 — MRS. KERRY LYNN HARRIS COTA
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1770609026 — MICHELLE BREAKEY PTA
Practice Location Address:
100 HIGH POINT DR
KANE, PA
16735-9704
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Practice Fax:
1518083203 — MRS. MARYBETH ELIAS
Practice Location Address:
100 HIGH POINT DR
KANE, PA
16735-9704
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Practice Fax:
1659497634 — KELLIE ELY MSPT
Practice Location Address:
100 HIGH POINT DR
KANE, PA
16735-9704
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Practice Fax: 814-837-9205
1790912335 — JESSICA A SHANNON OTR/L
Practice Location Address:
100 HIGH POINT DR
KANE, PA
16735-9704
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Directions to “LUTHERAN HOME AT KANE PENNSYLVANIA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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