MEDICARE: THE VERLAND FOUNDATION, 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	313M00000X	Nursing Facility/Intermediate Care Facility	806750	PA

General Provider Information

NPI Number	:	1871627745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VERLAND FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	212 IRIS RD
Second Line	:
City	:	SEWICKLEY
State	:	PA
Zip	:	15143-2402
Country	:	US
Telephone Number	:	412-741-2375
Fax Number	:	412-741-3299

Provider Business Practice Location Address
First Line	:	1511 HAWTHORNE ST
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1630
Country	:	US
Telephone Number	:	724-224-5695
Fax Number	:	412-741-3299

Authorized Official
Title or Position	:	CEO
Name	:	MS. CAROL MITCHELL
Credential	:
Telephone Number	:	412-741-2375

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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