Provider Demographics
NPI:1134662489
Name:MT. LEBANON OPERATIONS LLC
Entity Type:Organization
Organization Name:MT. LEBANON OPERATIONS LLC
Other - Org Name:MT. LEBANON REHABILITATION AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-257-4444
Mailing Address - Street 1:350 OLD GILKESON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1063
Mailing Address - Country:US
Mailing Address - Phone:412-257-4444
Mailing Address - Fax:
Practice Address - Street 1:350 OLD GILKESON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1063
Practice Address - Country:US
Practice Address - Phone:412-257-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility