Provider Demographics
NPI:1932150349
Name:GGNSC LANCASTER LP
Entity Type:Organization
Organization Name:GGNSC LANCASTER LP
Other - Org Name:GOLDEN LIVINGCENTER - LANCASTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC. OF THE GP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:425 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4905
Mailing Address - Country:US
Mailing Address - Phone:717-397-4281
Mailing Address - Fax:717-397-9187
Practice Address - Street 1:425 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4905
Practice Address - Country:US
Practice Address - Phone:717-397-4281
Practice Address - Fax:717-397-9187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA040702314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA53095OtherGEISINGER HEALTH PLAN
PA000000119187OtherTHREE RIVERS HEALTH PLAN
PA0005499000OtherINDEPENDENCE BLUE CROSS
PA101551917Medicaid
PA1519362OtherGATEWAY HEALTH PLAN
PA90740OtherHEALTH AMERICA
PA1015519170001Medicaid
PA2142OtherHIGHMARK CENTRAL FREEDOM
PA395177OtherCAPITAL BLUE CROSS
PA1015519170001Medicaid
CA395177Medicare Oscar/Certification