Active NPI
Valley Crest Nursing , L.P.
- Skilled Nursing Facility
- Wilkes Barre, PA
National Provider Identifier
1194798652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 220102
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014868460001 | Medicaid | PA |
Other names 1
- Valley Crest Nursing and Rehabilitation Center
National Provider Directory
National Provider DirectoryLocations
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.