Provider Demographics
NPI:1740231059
Name:GGNSC JOHNSTOWN LP
Entity Type:Organization
Organization Name:GGNSC JOHNSTOWN LP
Other - Org Name:GOLDEN LIVINGCENTER - RICHLAND
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 1:349 VO TECH DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-2926
Mailing Address - Country:US
Mailing Address - Phone:814-266-9702
Mailing Address - Fax:814-266-6950
Practice Address - Street 1:349 VO TECH DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2926
Practice Address - Country:US
Practice Address - Phone:814-266-9702
Practice Address - Fax:814-266-6950
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
PA440702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000090OtherUPMC
PA60047OtherGEISINGER HEALTH PLAN
PA1503895OtherGATEWAY HEALTH PLAN
PA000000092691OtherTHREE RIVERS HEALTH PLAN
PA0468OtherHIGHMARK WESTERN PA
PA101551514Medicaid
PA1015515140001Medicaid
CA395610Medicare Oscar/Certification
PA101551514Medicaid