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Organization
MAHONING VALLEY CONVALESCENT HOME, INC.
Active
Organization
MAHONING VALLEY CONVALESCENT HOME, INC.
Active
Other names
Mahoning Valley Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ANDREW MICKEY (PRESIDENT / C.E.O.)
(570) 386-5522
Entity
Organization
Contact information
Practice address
397 HEMLOCK DR, LEHIGHTON, PA 18235-9712
(570) 386-5522
(570) 386-3292
Mailing address
397 HEMLOCK DR, LEHIGHTON, PA 18235-9712
(570) 386-5522
(570) 386-3292
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130202
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007552770002
—
PA
Enumeration date
07/21/2005
Last updated
08/22/2020
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