# COUNTRYSIDE CONVALESCENT HOME LIMITED PARTNERSHIP

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

## Provider details

- **NPI number:** 1639917198
- **Authorized official:** MICHAEL MARKIVICH (CFO)
- **Authorized official phone:** (724) 431-0770

## Contact information

- **Practice address:** 8221 LAMOR ROAD, MERCER, PA 16137-3163
- **Practice address phone:** (724) 458-9501
- **Practice address fax:** (724) 662-1090
- **Mailing address:** 612 N MAIN ST, BUTLER, PA 16001-4363
- **Mailing address phone:** (724) 431-0770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/18/2024
- **Last updated:** 07/18/2024