Provider Demographics
NPI:1588812523
Name:TIMBERCRAFT INC
Entity Type:Organization
Organization Name:TIMBERCRAFT INC
Other - Org Name:POINT MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEWEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLWAGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-725-5533
Mailing Address - Street 1:300 UNION ST
Mailing Address - Street 2:
Mailing Address - City:POINT MARION
Mailing Address - State:PA
Mailing Address - Zip Code:15474-1062
Mailing Address - Country:US
Mailing Address - Phone:724-725-5533
Mailing Address - Fax:
Practice Address - Street 1:300 UNION ST
Practice Address - Street 2:
Practice Address - City:POINT MARION
Practice Address - State:PA
Practice Address - Zip Code:15474-1062
Practice Address - Country:US
Practice Address - Phone:724-725-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA405500310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility