Basic Information
Provider Information
NPI: 1861820839
EntityType: 2
ReplacementNPI:  
OrganizationName: AL SAXONBURG OPERATIONS, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ELMCROFT OF SAXONBURG
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9510 ORMSBY STATION RD
Address2: SUITE 101
City: LOUISVILLE
State: KY
PostalCode: 402234081
CountryCode: US
TelephoneNumber: 5027536004
FaxNumber: 5027536104
Practice Location
Address1: 100 BELLA CT
Address2:  
City: SAXONBURG
State: PA
PostalCode: 160562230
CountryCode: US
TelephoneNumber: 7243522827
FaxNumber: 7243523499
Other Information
ProviderEnumerationDate: 10/29/2013
LastUpdateDate: 10/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BARBER
AuthorizedOfficialFirstName: ROBIN
AuthorizedOfficialMiddleName: L.
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 5027536000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: JD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
310400000X423350PAY Nursing & Custodial Care FacilitiesAssisted Living Facility 

No ID Information.


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