Provider Demographics
NPI:1972507531
Name:ROLLING MEADOWS CARE, INC
Entity Type:Organization
Organization Name:ROLLING MEADOWS CARE, INC
Other - Org Name:ROLLING MEADOWS CARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-627-3153
Mailing Address - Street 1:107 CURRY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-3415
Mailing Address - Country:US
Mailing Address - Phone:724-627-3153
Mailing Address - Fax:724-627-9840
Practice Address - Street 1:107 CURRY RD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-3415
Practice Address - Country:US
Practice Address - Phone:724-627-3153
Practice Address - Fax:724-627-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA035402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0585OtherHIGHMARK BLUE CROSS
PA0015050630002Medicaid
PA0015050630002Medicaid