MEDICARE: ARDEN COURTS OF JEFFERSON HILLS PA LLC

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	310400000X	Assisted Living Facility	002300	PA

General Provider Information

NPI Number	:	1497700413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARDEN COURTS OF JEFFERSON HILLS PA LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-2615
Country	:	US
Telephone Number	:	419-252-5500
Fax Number	:	877-385-9446

Provider Business Practice Location Address
First Line	:	380 WRAY LARGE RD
Second Line	:
City	:	JEFFERSON HILLS
State	:	PA
Zip	:	15025-3836
Country	:	US
Telephone Number	:	412-384-0300
Fax Number	:	412-384-0700

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MARTIN D ALLEN
Credential	:
Telephone Number	:	419-252-5743

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/08/2017

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