Organization
MANOR AT ST. LUKE VILLAGE FACILITY OPERATIONS, LLC
Active
Other names
The Manor at St. Luke Village
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LEHNER (MANAGER)
(770) 698-9040
Entity
Organization
Contact information
Practice address
1711 E BROAD ST, HAZLETON, PA 18201-5691
(570) 453-5100
(570) 453-5138
Mailing address
1711 E BROAD ST, HAZLETON, PA 18201-5691
(570) 453-5100
(570) 453-5138
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018125210001
—
PA
Enumeration date
07/28/2006
Last updated
09/13/2024
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