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Organization

LAFAYETTE MANOR, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY KETTERMAN NHA (NURSING HOME ADMINISTRATOR)
(724) 430-4848
Entity
Organization

Contact information

Practice address
147 LAFAYETTE MANOR ROAD, UNIONTOWN, PA 15401-8900
(724) 430-4848
(724) 430-1881
Mailing address
147 LAFAYETTE MANOR ROAD, UNIONTOWN, PA 15401
(724) 430-4848
(724) 430-1881

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
409610
PA
314000000X
Skilled Nursing Facility
Primary
120202
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007479900003
PA
01
0544
BLUECROSS PROVIDER NUMBER
PA
Enumeration date
05/23/2005
Last updated
01/07/2025
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