# ASBURY ATLANTIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethany Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538133053
- **Authorized official:** MR. BRIAN GRUNDUSKY NHA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (717) 591-8027

## Contact information

- **Practice address:** 5225 WILSON LN, MECHANICSBURG, PA 17055-6663
- **Practice address phone:** (717) 591-8001
- **Practice address fax:** (717) 766-0870
- **Mailing address:** 5225 WILSON LN, MECHANICSBURG, PA 17055-6663
- **Mailing address phone:** (717) 591-8001
- **Mailing address fax:** (717) 766-0870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 024402 | PA | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 01/05/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1017505810003 | — | PA |