Provider Demographics
NPI:1356323109
Name:VALLEY NURSING AND REHABILITATION CENTER
Entity Type:Organization
Organization Name:VALLEY NURSING AND REHABILITATION CENTER
Other - Org Name:MOSSER NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:215-529-6228
Mailing Address - Street 1:2100 QUAKER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-2182
Mailing Address - Country:US
Mailing Address - Phone:215-536-6152
Mailing Address - Fax:215-529-6250
Practice Address - Street 1:1175 MOSSER RD
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1337
Practice Address - Country:US
Practice Address - Phone:610-395-5661
Practice Address - Fax:610-871-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133902314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010917520001Medicaid
PA395105Medicare ID - Type Unspecified