Organization
ASBURY ATLANTIC, INC.
Active
Other names
Bethany Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN GRUNDUSKY NHA (EXECUTIVE DIRECTOR)
(717) 591-8027
Entity
Organization
Contact information
Practice address
5225 WILSON LN, MECHANICSBURG, PA 17055-6663
(717) 591-8001
(717) 766-0870
Mailing address
5225 WILSON LN, MECHANICSBURG, PA 17055-6663
(717) 591-8001
(717) 766-0870
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
024402
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017505810003
—
PA
Enumeration date
02/13/2006
Last updated
01/05/2017
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