Organization
GREEN RIDGE HEALTH CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN CRAVEN NHA (ADMINISTRATOR)
(570) 344-6121
Entity
Organization
Contact information
Practice address
2741 BOULEVARD AVE, SCRANTON, PA 18509-1000
(570) 344-6121
Mailing address
2741 BOULEVARD AVE, SCRANTON, PA 18509-1000
(570) 344-6121
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
332302
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008394040001
—
PA
Enumeration date
01/02/2007
Last updated
08/22/2020
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