Provider Demographics
NPI:1649054511
Name:WILLOW VALLEY COMMUNITIES
Entity type:Organization
Organization Name:WILLOW VALLEY COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF RESIDENT HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KINSEY
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:717-464-6200
Mailing Address - Street 1:750 WILLOW VALLEY LAKES DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584
Mailing Address - Country:US
Mailing Address - Phone:717-464-6200
Mailing Address - Fax:717-464-6205
Practice Address - Street 1:750 WILLOW VALLEY LAKES DRIVE
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584
Practice Address - Country:US
Practice Address - Phone:717-464-6200
Practice Address - Fax:717-464-6205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLOW VALLEY COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty