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Organization
CHRIST THE KING MANOR
Active
Organization
CHRIST THE KING MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD A ANDRULONIS (CHIEF OPERATING OFFICER)
(814) 371-3180
Entity
Organization
Contact information
Practice address
1100 W LONG AVE, DU BOIS, PA 15801-3986
(814) 371-3180
(814) 371-4101
Mailing address
1100 W LONG AVE, DU BOIS, PA 15801-3986
(814) 371-3180
(814) 371-4101
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
18633601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316063324
—
PA
Enumeration date
05/10/2016
Last updated
02/24/2020
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