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NPI Code Detail

MEDICARE: OAK HRC MOUNTAIN LAUREL LLC

MEDICARE: OAK HRC MOUNTAIN LAUREL 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1598162398
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAK HRC MOUNTAIN LAUREL LLC
Provider Business Mailing Address
First Line : 700 LEONARD ST
Second Line :
City : CLEARFIELD
State : PA
Zip : 16830-3245
Country : US
Telephone Number : 814-765-7545
Fax Number :
Provider Business Practice Location Address
First Line : 700 LEONARD ST
Second Line :
City : CLEARFIELD
State : PA
Zip : 16830-3245
Country : US
Telephone Number : 814-765-7545
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : HOWARD JAFFE
Credential :
Telephone Number : 215-346-6454
Provider Enumeration Date : 11/24/2014
Last Update Date : 11/24/2014

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Directions to “OAK HRC MOUNTAIN LAUREL LLC ” Practice Location

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