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Organization
UNIVERSITY PARK NURSING, LP
Active
Organization
UNIVERSITY PARK NURSING, LP
Active
Other names
The Hearthside, A Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (PRESIDENT)
(215) 441-7700
Entity
Organization
Contact information
Practice address
450 WAUPELANI DRIVE, STATE COLLEGE, PA 16801-4516
(814) 237-0630
(814) 237-1803
Mailing address
450 WAUPELANI DRIVE, STATE COLLEGE, PA 16801-4516
(814) 237-0630
(814) 237-1803
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940502
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101188085
—
PA
05
—
4901777625
—
PA
Enumeration date
04/11/2006
Last updated
05/18/2009
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