Provider Demographics
NPI:1457166290
Name:TUNKHANNOCK REHABILITATION & HEALTH CARE CENTER OPERATING COMPANY LLC
Entity type:Organization
Organization Name:TUNKHANNOCK REHABILITATION & HEALTH CARE CENTER OPERATING COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-575-0744
Mailing Address - Street 1:401 MOLTKE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2886
Mailing Address - Country:US
Mailing Address - Phone:570-969-2188
Mailing Address - Fax:
Practice Address - Street 1:27 WEST ST
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1405
Practice Address - Country:US
Practice Address - Phone:570-996-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility