# LUTHERAN HOME AT KANE PENNSYLVANIA

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

## Provider details

- **NPI number:** 1457355091
- **Authorized official:** MRS. MEGAN M BOLDEN N.H.A. (ADMINISTRATOR)
- **Authorized official phone:** (814) 837-6706

## Contact information

- **Practice address:** 100 HIGH POINT DRIVE, KANE, PA 16735-9704
- **Practice address phone:** (814) 837-6706
- **Practice address fax:** (814) 837-1051
- **Mailing address:** 100 HIGH POINT DRIVE, KANE, PA 16735-9704
- **Mailing address phone:** (814) 837-6706
- **Mailing address fax:** (814) 837-1051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 902802 | PA | Yes |

## Other

- **Enumeration date:** 06/10/2005
- **Last updated:** 12/29/2014

## 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 |