Organization
THE LUTHERAN HOME FOR THE AGED D/B/A THE VILLAGE AT LUTHER SQUARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY P FOX MD (MEDICAL DIRECTOR)
(814) 456-5433
Entity
Organization
Contact information
Practice address
149 W 22ND ST, ERIE, PA 16502-2804
(814) 456-5433
(814) 456-0383
Mailing address
149 W 22ND ST, ERIE, PA 16502-2804
(814) 456-5433
(814) 456-0383
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000X
PA
Other
Enumeration date
05/08/2015
Last updated
05/08/2015
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