# NUGENT CONVALESCENT HOME, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417953837
- **Authorized official:** MR. ROBERT S FREED (ADMINISTRATOR)
- **Authorized official phone:** (724) 981-6610

## Contact information

- **Practice address:** 500 CLARKSVILLE RD, HERMITAGE, PA 16148-2954
- **Practice address phone:** (724) 981-6610
- **Practice address fax:** (724) 981-3224
- **Mailing address:** 500 CLARKSVILLE ROAD, HERMITAGE, PA 16148
- **Mailing address phone:** (724) 981-6610
- **Mailing address fax:** (724) 981-3224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1407 | PA | Yes |

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 01/29/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0645 | BLUE CROSS PROVIDER \# | PA |
| 01 | — | 313583 | UPMC HEALTH PLAN PROVIDER | PA |