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Organization
LOCUST GROVE FACILITY OPERATIONS, LLC
Active
Organization
LOCUST GROVE FACILITY OPERATIONS, LLC
Active
Other names
Locust Grove Retirement Village
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LEHNER (MANAGER)
(770) 698-9040
Entity
Organization
Contact information
Practice address
69 COTTAGE RD, MIFFLIN, PA 17058-7030
(717) 436-8921
(717) 436-9165
Mailing address
69 COTTAGE RD, MIFFLIN, PA 17058-7030
(717) 436-8921
(717) 436-9165
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018114080001
—
PA
Enumeration date
07/31/2006
Last updated
09/13/2024
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