Organization
WEST HAVEN MANOR, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN D TACK NHA (CEO)
(724) 431-0770
Entity
Organization
Contact information
Practice address
151 GOODVIEW DRIVE, APOLLO, PA 15613-8527
(724) 727-3451
(724) 727-2432
Mailing address
151 GOODVIEW DRIVE, APOLLO, PA 15613-8527
(724) 727-3451
(724) 727-2432
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
235502
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024978350001
—
PA
Enumeration date
10/17/2005
Last updated
08/14/2014
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