Organization
SHADYSIDE SNF HEALTHCARE LLC
Active
Other names
Ivy Park Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
5609 5TH AVE, PITTSBURGH, PA 15232-2601
(412) 362-3500
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/25/2024
Last updated
08/21/2024
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