Provider Demographics
NPI:1912039793
Name:MARTHA LLOYD INTERMEDIATE CARE FACILITY
Entity Type:Organization
Organization Name:MARTHA LLOYD INTERMEDIATE CARE FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ICF DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-297-2185
Mailing Address - Street 1:190 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-1131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:190 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-1131
Practice Address - Country:US
Practice Address - Phone:570-297-2185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities