# MAHONING VALLEY CONVALESCENT HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mahoning Valley Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598765489
- **Authorized official:** MR. MICHAEL ANDREW MICKEY (PRESIDENT / C.E.O.)
- **Authorized official phone:** (570) 386-5522

## Contact information

- **Practice address:** 397 HEMLOCK DR, LEHIGHTON, PA 18235-9712
- **Practice address phone:** (570) 386-5522
- **Practice address fax:** (570) 386-3292
- **Mailing address:** 397 HEMLOCK DR, LEHIGHTON, PA 18235-9712
- **Mailing address phone:** (570) 386-5522
- **Mailing address fax:** (570) 386-3292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 130202 | PA | Yes |

## Other

- **Enumeration date:** 07/21/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007552770002 | — | PA |