Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SUGAR CREEK REST, LTD PTR
Active
Organization
SUGAR CREEK REST, LTD PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN D TACK NHA (CEO)
(724) 431-0770
Entity
Organization
Contact information
Practice address
120 LAKESIDE DR, WORTHINGTON, PA 16262-5102
(724) 445-3146
(724) 445-3186
Mailing address
120 LAKESIDE DR, WORTHINGTON, PA 16262-5102
(724) 445-3146
(724) 445-3186
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
195002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000966807001
—
PA
01
—
0240400001
NHIC,CORP
MA
01
—
0613
HIGHMARK BC
—
01
—
1039012
GATEWAY HP
PA
01
—
111736
UNISON
PA
01
—
209144
UPMC
—
01
—
263510
HEALTH AMERICA
PA
Enumeration date
08/30/2005
Last updated
08/14/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers