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Organization
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES
Active
Organization
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES
Active
Other names
South Mountain Restoration Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LIGHT (ADMINISTRATOR)
(717) 772-2518
Entity
Organization
Contact information
Practice address
10058 S MOUNTAIN RD, SOUTH MOUNTAIN, PA 17261-0900
(717) 749-4000
(717) 749-4071
Mailing address
10058 S MOUNTAIN RD, SOUTH MOUNTAIN, PA 17261-0900
(717) 749-4000
(717) 749-4071
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
NULL
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100308518
—
PA
Enumeration date
11/25/2005
Last updated
10/04/2021
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