Provider Demographics
NPI:1942251301
Name:GGNSC MONROEVILLE LP
Entity Type:Organization
Organization Name:GGNSC MONROEVILLE LP
Other - Org Name:GOLDEN LIVINGCENTER - MONROEVILLE
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 1:4142 MONROEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2608
Mailing Address - Country:US
Mailing Address - Phone:412-856-7570
Mailing Address - Fax:412-373-4383
Practice Address - Street 1:4142 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2608
Practice Address - Country:US
Practice Address - Phone:412-856-7570
Practice Address - Fax:412-373-4383
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
PA026102314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1512805OtherGATEWAY HEALTH PLAN
PA112827OtherHEALTH AMERICA
PA000000076004OtherTHREE RIVERS HEALTH PLAN
PA1015498100001Medicaid
PA0593OtherHIGHMARK WESTERN PA
PA101549810Medicaid
PA107736OtherUPMC
PA112827OtherHEALTH AMERICA
PA107736OtherUPMC