Organization
COUNTRY MANOR LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORIE ANN HORNICK (ADMINISTRATOR)
(814) 479-2355
Entity
Organization
Contact information
Practice address
170 PHILLIPS ST, JEROME, PA 15937-0430
(814) 479-2355
(814) 479-4047
Mailing address
170 PHILLIPS ST, PO BOX 430, JEROME, PA 15937
(814) 479-2355
(814) 479-4047
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
001320
PA
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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