Organization
ARBUTUS PARK MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD W WILSON NHA (ADMINSTRATOR)
(814) 266-8621
Entity
Organization
Contact information
Practice address
207 OTTAWA STREET, JOHNSTOWN, PA 15904-2337
(814) 266-8621
(814) 266-5478
Mailing address
207 OTTAWA STREET, JOHNSTOWN, PA 15904-2337
(814) 266-8621
(814) 266-5478
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
012002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007549770001
—
PA
01
—
1328
BLUE CROSS BLUE SHIELD
PA
Enumeration date
11/07/2006
Last updated
11/29/2022
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