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Organization
LAFAYETTE MANOR, INC
Active
Organization
LAFAYETTE MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KETTERMAN NHA (NURSING HOME ADMINISTRATOR)
(724) 430-4848
Entity
Organization
Contact information
Practice address
147 LAFAYETTE MANOR ROAD, UNIONTOWN, PA 15401-8900
(724) 430-4848
(724) 430-1881
Mailing address
147 LAFAYETTE MANOR ROAD, UNIONTOWN, PA 15401
(724) 430-4848
(724) 430-1881
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
409610
PA
314000000X
Skilled Nursing Facility
Primary
120202
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007479900003
—
PA
01
—
0544
BLUECROSS PROVIDER NUMBER
PA
Enumeration date
05/23/2005
Last updated
01/07/2025
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