Provider Demographics
NPI:1891719498
Name:LUTHER RIDGE FACILITY OPERATIONS, LLC
Entity Type:Organization
Organization Name:LUTHER RIDGE FACILITY OPERATIONS, LLC
Other - Org Name:LUTHER RIDGE AT SEIDERS HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:USSERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-571-1550
Mailing Address - Street 1:160 RED HORSE RD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-4209
Mailing Address - Country:US
Mailing Address - Phone:570-621-7200
Mailing Address - Fax:
Practice Address - Street 1:160 RED HORSE RD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-4209
Practice Address - Country:US
Practice Address - Phone:570-621-7200
Practice Address - Fax:570-621-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility