Provider Demographics
NPI:1952493272
Name:JEWISH HOME OF GREATER HARRISBURG
Entity Type:Organization
Organization Name:JEWISH HOME OF GREATER HARRISBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GECKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-657-0700
Mailing Address - Street 1:4000 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1017
Mailing Address - Country:US
Mailing Address - Phone:717-657-0700
Mailing Address - Fax:717-657-9409
Practice Address - Street 1:4000 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1017
Practice Address - Country:US
Practice Address - Phone:717-657-0700
Practice Address - Fax:717-657-9409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3220060232310400000X
PA102002314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007472750002Medicaid
PA395372OtherLEGACY
PA395372Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PA402585Medicare PIN