Provider Demographics
NPI:1407162993
Name:HUTNINGDON NURSING AND REHABILITATION CENTER
Entity Type:Organization
Organization Name:HUTNINGDON NURSING AND REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-643-4210
Mailing Address - Street 1:1229 WARM SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-2350
Mailing Address - Country:US
Mailing Address - Phone:814-643-4210
Mailing Address - Fax:814-643-8175
Practice Address - Street 1:1229 WARM SPRINGS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2350
Practice Address - Country:US
Practice Address - Phone:814-643-4210
Practice Address - Fax:814-643-8175
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNTINGDON NURSING CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007564000003Medicaid
395297Medicare PIN