Organization
OP EVERETT, LLC
Active
Other names
Pennknoll Village
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CONTE (CHIEF OPERATING OFFICER)
(407) 571-1550
Entity
Organization
Contact information
Practice address
208 PENNKNOLL RD, EVERETT, PA 15537-6940
(814) 623-3200
(814) 623-3202
Mailing address
800 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751-6148
(407) 571-1550
(407) 571-1599
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
680602
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012268000001
—
PA
Enumeration date
06/08/2006
Last updated
08/22/2020
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