# ENVOY OF SOMERSET, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Siemon's Lakeview Manor Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386937399
- **Authorized official:** KENNETH USSERY (VP)
- **Authorized official phone:** (407) 571-1550

## Contact information

- **Practice address:** 228 SIEMON DR, SOMERSET, PA 15501-7055
- **Practice address phone:** (814) 443-2811
- **Practice address fax:** (814) 445-3210
- **Mailing address:** 228 SIEMON DR, SOMERSET, PA 15501-7055
- **Mailing address phone:** (814) 443-2811
- **Mailing address fax:** (814) 445-3210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 970202 | PA | Yes |

## Other

- **Enumeration date:** 05/24/2011
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1026044800001 | — | PA |