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Organization
GGNSC WILKES-BARRE II LP
Active
Organization
GGNSC WILKES-BARRE II LP
Active
Other names
Golden LivingCenter - Summit
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY A. RASMUSSEN-JONES (SEC. OF THE GP)
(479) 201-4835
Entity
Organization
Contact information
Practice address
50 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3503
(570) 825-3488
(570) 825-9423
Mailing address
50 N PENNSYLVANIA AVE, WILKES BARRE, PA 18701-3503
(570) 825-3488
(570) 825-9423
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
971402
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130630
THREE RIVERS HEALTH PLAN
PA
05
—
101558613
—
PA
05
—
1015586130001
—
PA
01
—
1526893
GATEWAY HEALTH PLAN
PA
01
—
30946
GEISINGER HEALTH PLAN
PA
Enumeration date
05/12/2006
Last updated
07/16/2014
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