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Organization

NUGENT CONVALESCENT HOME, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT S FREED (ADMINISTRATOR)
(724) 981-6610
Entity
Organization

Contact information

Practice address
500 CLARKSVILLE RD, HERMITAGE, PA 16148-2954
(724) 981-6610
(724) 981-3224
Mailing address
500 CLARKSVILLE ROAD, HERMITAGE, PA 16148
(724) 981-6610
(724) 981-3224

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1407
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0645
BLUE CROSS PROVIDER #
PA
01
313583
UPMC HEALTH PLAN PROVIDER
PA
Enumeration date
06/21/2005
Last updated
01/29/2009
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