Organization
CENTRE CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD J BRUNO (ADMINISTRATOR)
(814) 355-6777
Entity
Organization
Contact information
Practice address
502 E HOWARD ST, BELLEFONTE, PA 16823
(814) 355-6777
(814) 355-6999
Mailing address
502 E HOWARD ST, BELLEFONTE, PA 16823
(814) 355-6777
(814) 355-6999
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031702
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031702
DOH STATE LICENSE NUMBER
PA
05
—
1007296630007
—
PA
Enumeration date
06/22/2005
Last updated
08/22/2020
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