Organization
PLEASANT RIDGE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT V SMITH NHA (EXECUTIVE DIRECTOR)
(814) 474-5521
Entity
Organization
Contact information
Practice address
8300 RIDGE RD, GIRARD, PA 16417-8701
(814) 474-5521
(814) 474-9253
Mailing address
8300 RIDGE RD, GIRARD, PA 16417-8701
(814) 474-5521
(814) 474-9253
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
050902
PA
314000000X
Skilled Nursing Facility
Primary
311002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0536
BLUE CROSS
PA
05
—
1007744350006
—
PA
Enumeration date
10/03/2005
Last updated
08/22/2020
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