Provider Demographics
NPI:1629180732
Name:890 WEATHERWOOD LANE OPERATING COMPANY, LLC
Entity Type:Organization
Organization Name:890 WEATHERWOOD LANE OPERATING COMPANY, LLC
Other - Org Name:THE REHABILITATION & NURSING CENTER AT GREATER PITTSBURGH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, SPECIAL PROJECTS
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-930-6051
Mailing Address - Street 1:890 WEATHERWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-837-8016
Mailing Address - Fax:724-837-3152
Practice Address - Street 1:890 WEATHERWOOD LANE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-837-8016
Practice Address - Fax:724-837-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
39-5851Medicare ID - Type Unspecified