Provider Demographics
NPI:1457329294
Name:MEADOWVIEW MANOR REHABILITATION SERVICES, INC.
Entity Type:Organization
Organization Name:MEADOWVIEW MANOR REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-542-8630
Mailing Address - Street 1:14330 CROGHAN PIKE
Mailing Address - Street 2:
Mailing Address - City:MOUNT UNION
Mailing Address - State:PA
Mailing Address - Zip Code:17066
Mailing Address - Country:US
Mailing Address - Phone:814-542-8630
Mailing Address - Fax:814-542-2828
Practice Address - Street 1:14330 CROGHAN PIKE
Practice Address - Street 2:
Practice Address - City:MOUNT UNION
Practice Address - State:PA
Practice Address - Zip Code:17066
Practice Address - Country:US
Practice Address - Phone:814-542-8630
Practice Address - Fax:814-542-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2016-08-04
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02662700OtherCAPITAL BLUE CROSS
PA516506OtherBLUE SHIELD
PA52044OtherGEISINGER
PA52044OtherGEISINGER