Provider Demographics
NPI:1245231208
Name:CPSR ASSOCIATES LLC
Entity type:Organization
Organization Name:CPSR ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIPEPI
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:724-310-1111
Mailing Address - Street 1:200 STOOPS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063
Mailing Address - Country:US
Mailing Address - Phone:724-310-1111
Mailing Address - Fax:724-310-1195
Practice Address - Street 1:200 STOOPS DRIVE
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063
Practice Address - Country:US
Practice Address - Phone:724-310-1111
Practice Address - Fax:724-310-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11790201314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019291830001Medicaid
PA1818OtherHIGHMARK BCBS
PA319068OtherUPMC
PA1818OtherHIGHMARK BC/BS
396085Medicare Oscar/Certification