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PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES

Intermediate Care Facility, Mentally Retarded

Ebensburg, Pennsylvania

Provider NPI: 1154304483

Organization Information:
Organization Name:  PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES


Practice Location:
4051 ADMIRAL PEARY HWY  EBENSBURG, PA 15931 US
Tel: 814-472-0200  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded

Other Provider Identifiers:

IssuerNumberStateType
100308518PA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS PA - Page 1



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