# MANOR AT ST. LUKE VILLAGE FACILITY OPERATIONS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Manor at St. Luke Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275547036
- **Authorized official:** TIM LEHNER (MANAGER)
- **Authorized official phone:** (770) 698-9040

## Contact information

- **Practice address:** 1711 E BROAD ST, HAZLETON, PA 18201-5691
- **Practice address phone:** (570) 453-5100
- **Practice address fax:** (570) 453-5138
- **Mailing address:** 1711 E BROAD ST, HAZLETON, PA 18201-5691
- **Mailing address phone:** (570) 453-5100
- **Mailing address fax:** (570) 453-5138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 09/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1018125210001 | — | PA |