Organization
ERIE INDEPENDENCE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID G SCHLAUDECKER (EXECUTIVE DIRECTOR)
(814) 461-9188
Entity
Organization
Contact information
Practice address
3108 ZUCK RD, ERIE, PA 16506-3161
(814) 833-9955
(814) 835-1772
Mailing address
1611 PEACH ST, SUITE 145, ERIE, PA 16501-2109
(814) 461-9188
(814) 461-0232
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
805640
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007694800001
—
PA
Enumeration date
03/07/2007
Last updated
08/22/2020
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