Organization
KINGSTON HEALTH CARE CENTER LLC
Active
Other names
Kingston Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL P KELLY (MANAGING MEMBER)
(570) 969-2188
Entity
Organization
Contact information
Practice address
702 3RD AVE, KINGSTON, PA 18704-5845
(570) 283-5848
(570) 383-5152
Mailing address
401 MOLTKE AVE, SUITE 100, SCRANTON, PA 18505-2886
(570) 969-2188
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
068502
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102787826-0001
—
PA
Enumeration date
09/27/2005
Last updated
05/16/2013
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