MEDICARE: GARDEN SPOT VILLAGE

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	261QA0600X	Adult Day Care Clinic/Center
2	314000000X	Skilled Nursing Facility	14350200	PA

General Provider Information

NPI Number	:	1912072414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDEN SPOT VILLAGE

Provider Business Mailing Address
First Line	:	433 S KINZER AVE
Second Line	:
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-9360
Country	:	US
Telephone Number	:	717-355-6006
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 S KINZER AVE
Second Line	:
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-9360
Country	:	US
Telephone Number	:	717-355-6006
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	NATHANIEL WEBER
Credential	:
Telephone Number	:	717-355-6049

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	10/23/2023

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Directions to “GARDEN SPOT VILLAGE ” Practice Location

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