Organization
THI OF PENNSYLVANIA AT GREENERY OF CANONSBURG LLC
Active
Other names
Greenery Specialty Care Center of Canonsburg
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LEROY (ADMINISTRATOR)
(724) 745-8000
Entity
Organization
Contact information
Practice address
2200 HILL CHURCH HOUSTON RD, CANONSBURG, PA 15317-1454
(724) 745-8000
(724) 745-3245
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
135602
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019578760001
—
PA
Enumeration date
10/03/2005
Last updated
06/29/2011
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