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Organization
KINGSTON HEALTH CARE CENTER LLC
Active
Organization
KINGSTON HEALTH CARE CENTER LLC
Active
Other names
Kingston Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL P KELLY (MANAGING MEMBER)
(570) 969-2188
Entity
Organization
Contact information
Practice address
702 3RD AVE, KINGSTON, PA 18704-5845
(570) 283-5848
(570) 383-5152
Mailing address
401 MOLTKE AVE, SUITE 100, SCRANTON, PA 18505-2886
(570) 969-2188
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
068502
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102787826-0001
—
PA
Enumeration date
09/27/2005
Last updated
05/16/2013
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