Provider Demographics
NPI:1467403865
Name:GGNSC MEYERSDALE LP
Entity Type:Organization
Organization Name:GGNSC MEYERSDALE LP
Other - Org Name:GOLDEN LIVINGCENTER - MEYERSDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC. OF THE GP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:201 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MEYERSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15552-1249
Mailing Address - Country:US
Mailing Address - Phone:814-634-5966
Mailing Address - Fax:814-634-8729
Practice Address - Street 1:201 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MEYERSDALE
Practice Address - State:PA
Practice Address - Zip Code:15552-1249
Practice Address - Country:US
Practice Address - Phone:814-634-5966
Practice Address - Fax:814-634-8729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101558023Medicaid
PA302175OtherUPMC
PA126208OtherHEALTH AMERICA
PA1504501OtherGATEWAY HEALTH PLAN
PA0471OtherHIGHMARK WESTERN PA
PA1015580230001Medicaid
PA000000098248OtherTHREE RIVERS HEALTH PLAN
PA126208OtherHEALTH AMERICA
PA101558023Medicaid