Basic Information
| Provider Information | |||||||||
| NPI: | 1508358292 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LUZERNE REHABILITATION & NURSING LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | KADIMA REHABILITATION & NURSING AT LUZERNE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 463 N HUNTER HWY | ||||||||
| Address2: | |||||||||
| City: | DRUMS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182222129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707884175 | ||||||||
| FaxNumber: | 5707884777 | ||||||||
| Practice Location | |||||||||
| Address1: | 463 N HUNTER HWY | ||||||||
| Address2: | |||||||||
| City: | DRUMS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182222129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707884175 | ||||||||
| FaxNumber: | 5707884777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2018 | ||||||||
| LastUpdateDate: | 05/30/2018 | ||||||||
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| AuthorizedOfficialLastName: | STRAUSS | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2012148889 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.