Organization
ALPINE MANOR, INC.
Active
Other names
Erie at Bayside
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE M. DUAY III CPA (CFO)
(305) 892-1790
Entity
Organization
Contact information
Practice address
4114 SCHAPER AVE, ERIE, PA 16508-3350
(305) 892-1790
(305) 538-2699
Mailing address
1680 MICHIGAN AVE, SUITE 736, MIAMI BEACH, FL 33139-2538
(305) 892-1790
(305) 538-2699
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
530402
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4163612
—
PA
Enumeration date
05/14/2007
Last updated
08/22/2020
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