Organization
CHRIST THE KING MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA FELTON-WERNER NHA (ADMINISTRATOR)
(814) 371-3180
Entity
Organization
Contact information
Practice address
1100 WEST LONG AVENUE, DUBOIS, PA 15801
(814) 371-3180
(814) 371-4101
Mailing address
P.O. BOX 448, DUBOIS, PA 15801
(814) 371-3180
(814) 371-4101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
290102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007457620001
—
PA
01
—
0689
BLUE CROSS BLUE SHIELD
PA
Enumeration date
03/21/2007
Last updated
02/24/2020
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