1265435952 NPI number — ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.

Table of content: (NPI 1265435952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265435952 NPI number — ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE LUTHERAN HOME AT HOLLIDAYSBURG
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265435952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
916 HICKORY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLIDAYSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16648-2248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-696-4500
Provider Business Mailing Address Fax Number:
814-696-4561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
915 HICKORY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLIDAYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16648-2247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-696-4500
Provider Business Practice Location Address Fax Number:
814-696-4561
Provider Enumeration Date:
05/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SAVAGE
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
814-696-4518

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  10502 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0635 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1001998070016 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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