# MID-VALLEY HEALTH CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mid-Valley Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225024003
- **Authorized official:** MR. MICHAEL P KELLY (MANAGING MEMBER)
- **Authorized official phone:** (570) 969-2188

## Contact information

- **Practice address:** 81 STURGES RD, PECKVILLE, PA 18452-1302
- **Practice address phone:** (570) 383-7320
- **Practice address fax:** (570) 383-5152
- **Mailing address:** 401 MOLTKE AVE, SUITE 100, SCRANTON, PA 18505-2886
- **Mailing address phone:** (570) 969-2188
- **Mailing address fax:** (570) 969-2189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 027502 | PA | Yes |

## Other

- **Enumeration date:** 09/27/2005
- **Last updated:** 05/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 102794713-0001 | — | PA |