Provider Demographics
NPI:1114271962
Name:MOUNT MACRINA MANOR NURSING HOME
Entity Type:Organization
Organization Name:MOUNT MACRINA MANOR NURSING HOME
Other - Org Name:MOUNT MACRINA REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENFORD
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:724-430-1121
Mailing Address - Street 1:520 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2602
Mailing Address - Country:US
Mailing Address - Phone:724-437-1400
Mailing Address - Fax:724-430-2438
Practice Address - Street 1:520 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2602
Practice Address - Country:US
Practice Address - Phone:724-437-1400
Practice Address - Fax:724-430-2438
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT MACRINA MANOR NURSING HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty