Provider Demographics
NPI:1619419207
Name:THE MEADOWS AT SUMMIT FOR NURSING AND REHABILITATION LLC
Entity Type:Organization
Organization Name:THE MEADOWS AT SUMMIT FOR NURSING AND REHABILITATION LLC
Other - Org Name:THE GARDENS AT WYOMING VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AKIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLATZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-505-0000
Mailing Address - Street 1:99 W HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-3503
Practice Address - Country:US
Practice Address - Phone:570-825-3488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility