Provider Demographics
NPI:1659322030
Name:GGNSC MURRYSVILLE LP
Entity Type:Organization
Organization Name:GGNSC MURRYSVILLE LP
Other - Org Name:GOLDEN LIVINGCENTER - MURRYSVILLE
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 1:3300 LOGAN FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1205
Mailing Address - Country:US
Mailing Address - Phone:724-325-1500
Mailing Address - Fax:724-325-3859
Practice Address - Street 1:3300 LOGAN FERRY RD
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1205
Practice Address - Country:US
Practice Address - Phone:724-325-1500
Practice Address - Fax:724-325-3859
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
PA134702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000088910OtherTHREE RIVERS HEALTH PLAN
PA1015509560001Medicaid
PA210005OtherUPMC
PA100209OtherHEALTH AMERICA
PA101550956Medicaid
PA0680OtherHIGHMARK WESTERN PA
PA1026639OtherGATEWAY HEALTH PLAN
PA101550956Medicaid
CA395295Medicare Oscar/Certification