Organization
CONCORDIA LUTHERAN HEALTH AND HUMAN CARE
Active
Parent organization
CONCORDIA LUTHERAN MINISTRIES
Other names
CLM Outpatient Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONCORDIA LUTHERAN MINISTRIES
Authorized official
MS. CHARLENE KISH (VICE PRESIDENT OF SKILLED NURSING)
(724) 352-1571
Entity
Organization
Contact information
Practice address
134 MARWOOD RD, CABOT, PA 16023-2206
(724) 352-1571
(724) 352-2740
Mailing address
134 MARWOOD RD, CABOT, PA 16023-2206
(724) 352-1571
(724) 352-2740
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
900202
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
396756
OUTPATIENT THERAPY MEDICARE PROVIDER NUMBER
PA
05
—
MA1001336090003
—
PA
Enumeration date
06/10/2005
Last updated
04/08/2016
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