Provider Demographics
NPI:1649221045
Name:GGNSC HASTINGS LP
Entity Type:Organization
Organization Name:GGNSC HASTINGS LP
Other - Org Name:GOLDEN LIVINGCENTER - HAIDA
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 1:397 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16646-6110
Mailing Address - Country:US
Mailing Address - Phone:814-247-6578
Mailing Address - Fax:814-247-9225
Practice Address - Street 1:397 3RD AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:PA
Practice Address - Zip Code:16646-6110
Practice Address - Country:US
Practice Address - Phone:814-247-6578
Practice Address - Fax:814-247-9225
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
PA340102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1504313OtherGATEWAY HEALTH PLAN
PA101557750Medicaid
PA0470OtherHIGHMARK WESTERN PA
PA000102OtherUPMC
PA1015577500001Medicaid
PA43366OtherGEISINGER HEALTH PLAN
CA395592Medicare Oscar/Certification
PA1504313OtherGATEWAY HEALTH PLAN