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Organization
LUTHERAN HOME AT KANE PENNSYLVANIA
Active
Organization
LUTHERAN HOME AT KANE PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN M BOLDEN N.H.A. (ADMINISTRATOR)
(814) 837-6706
Entity
Organization
Contact information
Practice address
100 HIGH POINT DRIVE, KANE, PA 16735-9704
(814) 837-6706
(814) 837-1051
Mailing address
100 HIGH POINT DRIVE, KANE, PA 16735-9704
(814) 837-6706
(814) 837-1051
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
902802
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000065056X
HUMANA
PA
05
—
1003684090004
—
PA
01
—
1217
HIGHMARK
PA
01
—
1603554
GATEWAY HEALTH PLAN
PA
01
—
30015545
AMERIHEALTH MERCY HEALTH PLAN
PA
01
—
729732
UPMC
PA
Enumeration date
06/10/2005
Last updated
12/29/2014
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