Presbyterian Home of Redstone Presbytery

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

680102 Issued in PA

Legal business name

PRESBYTERIAN HOME OF REDSTONE PRESBYTERY

Practice address

787 Goucher St
Johnstown, PA 15905-3028

Phone

(814) 255-5539

Fax

(814) 254-1809

NPI assigned

Aug 21, 2006

Last updated

Aug 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Timothy John Reeves, PCA

Title

Administrator

Phone

(814) 255-5539

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1275649634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 GOUCHER ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053028",
            "telephone_number": "814-255-5539",
            "fax_number": "814-254-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 GOUCHER ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053028",
            "telephone_number": "814-255-5539",
            "fax_number": "814-254-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOME OF REDSTONE PRESBYTERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "814-255-5539",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PCA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "PA",
            "license": "680102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility/Intermediate Care Facility in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Nursing Facility/Intermediate Care Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.