Organization Active NPI

Guardian Elder Care at Erie III LLC

  • Skilled Nursing Facility
  • Erie, PA
National Provider Identifier
1093219040
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GUARDIAN ELDER CARE AT ERIE III LLC
Practice address
1267 S Hill Rd
Erie, PA 16509-4831
Phone
(814) 864-4081
NPI assigned
Mar 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Eperesi
Title
Cfo
Phone
(814) 265-1164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1267 S Hill Rd
Erie, PA 16509-4831

Mailing address

8796 Route 219
Brockway, PA 15824-6010

Other identifiers 1

IdentifierTypeStateIssuer
103496690-0001MedicaidPA

Other names 1

  • Abington Crest Healthcare and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1093219040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8796 ROUTE 219",
            "city": "BROCKWAY",
            "state": "PA",
            "postal_code": "158246010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 S HILL RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165094831",
            "telephone_number": "814-864-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ELDER CARE AT ERIE III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "EPERESI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-265-1164"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103496690-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abington Crest Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.