Organization Active NPI

Valley Crest Nursing , L.P.

  • Skilled Nursing Facility
  • Wilkes Barre, PA
National Provider Identifier
1194798652
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
220102 Issued in PA
Legal business name
VALLEY CREST NURSING , L.P.
Practice address
1551 East End Blvd. Plains TWP.
Wilkes Barre, PA 18711-0575
Phone
(570) 826-1011
NPI assigned
Feb 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Peter J Licari
Title
President of General Partner
Phone
(215) 441-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 220102 PA Primary

Addresses

Primary practice location

1551 East End Blvd. Plains TWP.
Wilkes Barre, PA 18711-0575

Mailing address

120 Gibraltar Road
Suite 310
Horsham, PA 19044-2350
Phone (215) 441-7700

Other identifiers 1

IdentifierTypeStateIssuer
1014868460001MedicaidPA

Other names 1

  • Valley Crest Nursing and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

Locations

120 Gibraltar Rd
Ste 310
Horsham, PA 19044

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194798652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GIBRALTAR ROAD",
            "address_2": "SUITE 310",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442350",
            "telephone_number": "215-441-7700",
            "fax_number": "215-441-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 EAST END BLVD. PLAINS TWP.",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110575",
            "telephone_number": "570-826-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CREST NURSING , L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OF GENERAL PARTNER",
        "authorized_official_telephone_number": "215-441-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "220102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014868460001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Crest Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.