Covilles Personal Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

424710 Issued in PA

Legal business name

COVILLES PERSONAL CARE HOME

Practice address

5 S 2ND St
Masontown, PA 15461-1538

Phone

(724) 583-0744

Fax

(724) 583-0350

NPI assigned

Mar 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Dominick William Coville II, R.N.

Title

Administrator

Phone

(724) 583-9227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1194996355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SOUTH 2ND ST.",
            "city": "MASONTOWN",
            "state": "PA",
            "postal_code": "15461",
            "telephone_number": "724-583-0744",
            "fax_number": "724-583-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S 2ND ST",
            "city": "MASONTOWN",
            "state": "PA",
            "postal_code": "154611538",
            "telephone_number": "724-583-0744",
            "fax_number": "724-583-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVILLES PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "COVILLE",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "724-583-9227",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "PA",
            "license": "424710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.