Provider Demographics
NPI:1558312959
Name:GGNSC LANSDALE LP
Entity Type:Organization
Organization Name:GGNSC LANSDALE LP
Other - Org Name:GOLDEN LIVINGCENTER - LANSDALE
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 1:25 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2424
Mailing Address - Country:US
Mailing Address - Phone:215-855-9765
Mailing Address - Fax:215-368-6162
Practice Address - Street 1:25 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2424
Practice Address - Country:US
Practice Address - Phone:215-855-9765
Practice Address - Fax:215-368-6162
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
PA140502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015524500001Medicaid
PA101552450Medicaid
PA0005475000OtherINDEPENDENCE BLUE CROSS
CA395256Medicare Oscar/Certification
PA101552450Medicaid