Provider Demographics
NPI:1467459313
Name:ORCHARD MANOR INC
Entity Type:Organization
Organization Name:ORCHARD MANOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:724-458-7760
Mailing Address - Street 1:20 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-6328
Mailing Address - Country:US
Mailing Address - Phone:724-458-7760
Mailing Address - Fax:724-458-0588
Practice Address - Street 1:20 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-6328
Practice Address - Country:US
Practice Address - Phone:724-458-7760
Practice Address - Fax:724-458-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA410802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007509690002Medicaid
PA395793Medicare Oscar/Certification