# WILLIAMSPORT SOUTH OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Williamsport South Rehabilitation and Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760068381
- **Authorized official:** JACOB J ZAHLER (AUTHORIZED MEMBER)
- **Authorized official phone:** (908) 912-2700

## Contact information

- **Practice address:** 101 LEADER DR, WILLIAMSPORT, PA 17701-1942
- **Practice address phone:** (570) 323-3758
- **Practice address fax:** (570) 323-9228
- **Mailing address:** 101 LEADER DR, WILLIAMSPORT, PA 17701-1942
- **Mailing address phone:** (570) 323-3758
- **Mailing address fax:** (570) 323-9228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/23/2021
- **Last updated:** 12/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103891927-0001 | — | PA |