Organization
BONNIEVILLE INC.
Active
Other names
Bonham Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES K. BONHAM JR. (PRESIDENT)
(570) 864-3174
Entity
Organization
Contact information
Practice address
477 BONNIEVILLE RD, STILLWATER, PA 17878-9211
(570) 864-3174
(570) 864-3897
Mailing address
477 BONNIEVILLE RD, STILLWATER, PA 17878-9211
(570) 864-3174
(570) 864-3897
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
022802
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031076580001
—
PA
Enumeration date
12/07/2005
Last updated
08/05/2016
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