# MANOR CARE OF WILLIAMSPORT PA (SOUTH) LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ManorCare Health Services - Williamsport South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861431199
- **Authorized official:** MR. MARTIN D ALLEN (DIRECTOR)
- **Authorized official phone:** (419) 252-5743

## 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:** 333 N SUMMIT ST, TOLEDO, OH 43604-2615
- **Mailing address phone:** (419) 252-5500
- **Mailing address fax:** (877) 385-9446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 641502 | PA | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 05/09/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1020618860001 | — | PA |