Organization
COUNTY OF INDIANA
Active
Parent organization
COUNTY OF INDIANA
Other names
The Communities at Indian Haven
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF INDIANA
Authorized official
MRS. KIMBERLY COBAUGH RNC, MSN, NHA (ADMINISTRATOR)
(724) 465-3900
Entity
Organization
Contact information
Practice address
1675 SALTSBURG AVE, INDIANA, PA 15701-3573
(724) 465-3900
(724) 465-2013
Mailing address
1675 SALTSBURG AVE, INDIANA, PA 15701-3573
(724) 465-3900
(724) 465-2013
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
090102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007463790005
—
PA
01
—
643
BLUE CORSS
PA
01
—
6433
BLUE CROSS
PA
Enumeration date
11/28/2005
Last updated
12/16/2015
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