Provider Demographics
NPI:1336122043
Name:FRIENDS OF THE ZENDT HOME INC.
Entity Type:Organization
Organization Name:FRIENDS OF THE ZENDT HOME INC.
Other - Org Name:ZENDT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NHA
Authorized Official - Phone:717-694-3434
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17086-0248
Mailing Address - Country:US
Mailing Address - Phone:717-694-3434
Mailing Address - Fax:717-694-3626
Practice Address - Street 1:MAIN ST.
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:PA
Practice Address - Zip Code:17086
Practice Address - Country:US
Practice Address - Phone:717-694-3434
Practice Address - Fax:717-694-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA260202314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100981216-0001Medicaid
PA100981216-0001Medicaid