# COUNTRYSIDE CHRISTIAN COMMUNITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225040751
- **Authorized official:** MISS MARY ELLEN ROHRER (ADMINISTRATOR)
- **Authorized official phone:** (717) 867-4636

## Contact information

- **Practice address:** 200 BELLANN CT, ANNVILLE, PA 17003-9012
- **Practice address phone:** (717) 867-4636
- **Practice address fax:** (717) 867-1332
- **Mailing address:** 200 BELLANN CT, ANNVILLE, PA 17003-9012
- **Mailing address phone:** (717) 867-4636
- **Mailing address fax:** (717) 867-1332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 470802 | PA | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1014899550001 | — | PA |