Organization
LEBANON VALLEY BRETHREN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS F GARRETT (CFO, VP FINANCE)
(717) 838-5406
Entity
Organization
Contact information
Practice address
1200 GRUBB RD, PALMYRA, PA 17078-3514
(717) 838-5406
(717) 641-0073
Mailing address
1200 GRUBB RD, PALMYRA, PA 17078-3514
(717) 838-5406
(717) 641-0073
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
380602
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002291290002
—
PA
Enumeration date
07/12/2005
Last updated
11/19/2015
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