Provider Demographics
NPI:1477504850
Name:GGNSC CLARION LP
Entity Type:Organization
Organization Name:GGNSC CLARION LP
Other - Org Name:GOLDEN LIVINGCENTER - CLARION
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 1:999 HEIDRICK ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1745
Mailing Address - Country:US
Mailing Address - Phone:814-226-6380
Mailing Address - Fax:814-226-5177
Practice Address - Street 1:999 HEIDRICK ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1745
Practice Address - Country:US
Practice Address - Phone:814-226-6380
Practice Address - Fax:814-226-5177
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
PA591202314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000092593OtherTHREE RIVERS HEALTH PLAN
PA0459OtherHIGHMARK WESTERN PA
PA1015489850001Medicaid
PA126205OtherHEALTH AMERICA
PA1519917OtherGATEWAY HEALTH PLAN
PA323951OtherUPMC
PA101548985Medicaid
PA126205OtherHEALTH AMERICA
CA395707Medicare Oscar/Certification