Provider Demographics
NPI:1649264672
Name:MERCY CENTER NURSING UNIT
Entity type:Organization
Organization Name:MERCY CENTER NURSING UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:570-675-2131
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-0370
Mailing Address - Country:US
Mailing Address - Phone:570-675-2131
Mailing Address - Fax:570-674-5658
Practice Address - Street 1:301 LAKE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-7752
Practice Address - Country:US
Practice Address - Phone:570-675-2131
Practice Address - Fax:570-674-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA015502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012388540001Medicaid
PA395850Medicare PIN