Provider Demographics
NPI:1457375081
Name:HCF OF BRADFORD, INC.
Entity Type:Organization
Organization Name:HCF OF BRADFORD, INC.
Other - Org Name:BRADFORD MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - CORPORATE COMPLIANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STECHSCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-2010
Mailing Address - Street 1:50 LANGMAID LN
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-3930
Mailing Address - Country:US
Mailing Address - Phone:814-362-6090
Mailing Address - Fax:814-362-2841
Practice Address - Street 1:50 LANGMAID LN
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-3930
Practice Address - Country:US
Practice Address - Phone:814-362-6090
Practice Address - Fax:814-362-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA282702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000099844OtherTHREE RIVERS/UNISON
PA0019250120001Medicaid
PA1636712-01OtherUPMC
PA228044OtherADVANTRA
PA0035OtherSECURITY BLUE
NY01014846Medicaid
PA0019250120001Medicaid