Organization
GGNSC ERIE WESTERN RESERVE LP
Active
Other names
Golden LivingCenter - Western Reserve
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY A. RASMUSSEN-JONES (SEC. OF THE GP)
(479) 201-4835
Entity
Organization
Contact information
Practice address
1521 W 54TH ST, ERIE, PA 16509-2620
(814) 864-0671
(814) 866-5681
Mailing address
1521 W 54TH ST, ERIE, PA 16509-2620
(814) 864-0671
(814) 866-5681
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
490802
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000079448
THREE RIVERS HEALTH PLAN
PA
05
—
00745097
—
NY
01
—
0656
HIGHMARK WESTERN PA
PA
01
—
1007774460023
ION HEALTH
PA
05
—
101551864
—
PA
05
—
1015518640001
—
PA
01
—
1505090
GATEWAY HEALTH PLAN
PA
01
—
318038
UPMC
PA
01
—
84012
HEALTH AMERICA
PA
Enumeration date
05/12/2006
Last updated
07/16/2014
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