Provider Demographics
NPI:1083628085
Name:HCF OF SWEDEN VALLEY, INC.
Entity Type:Organization
Organization Name:HCF OF SWEDEN VALLEY, INC.
Other - Org Name:SWEDEN VALLEY MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - FINANCE & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:UNVERFERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-2010
Mailing Address - Street 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3583
Mailing Address - Country:US
Mailing Address - Phone:419-999-2010
Mailing Address - Fax:419-999-6284
Practice Address - Street 1:1028 E 2ND ST
Practice Address - Street 2:
Practice Address - City:COUDERSPORT
Practice Address - State:PA
Practice Address - Zip Code:16915-8306
Practice Address - Country:US
Practice Address - Phone:814-274-7610
Practice Address - Fax:814-274-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA455402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000099832OtherTHREE RIVERS/UNISON
PA0019252000001Medicaid
NY00926325Medicaid
PA0052OtherSECURITY BLUE
PA305047OtherADVANTRA
NY00926325Medicaid