Provider Demographics
NPI:1982679437
Name:ALLEGHENY CHRISTIAN MINISTRIES, INC.
Entity Type:Organization
Organization Name:ALLEGHENY CHRISTIAN MINISTRIES, INC.
Other - Org Name:LAUREL VIEW VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:MISHLER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:814-288-2724
Mailing Address - Street 1:2000 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9220
Mailing Address - Country:US
Mailing Address - Phone:814-288-2724
Mailing Address - Fax:814-288-4278
Practice Address - Street 1:2000 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:DAVIDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15928-9220
Practice Address - Country:US
Practice Address - Phone:814-288-2724
Practice Address - Fax:814-288-4278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA043702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013989000002Medicaid
PA043702OtherLONG TERM CARE LICENSE
PA395891Medicare ID - Type Unspecified