Reliant Audubon Holdings LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RELIANT AUDUBON HOLDINGS LLC

Doing business as

Audubon Villa Health and Rehabilitation Center

Practice address

125 S Broad St
Lititz, PA 17543-1808

Phone

(717) 626-0211

NPI assigned

Apr 17, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Marc Myzal

Title

Coo

Phone

(215) 558-3700

Specialties & licenses 2

Addresses

Other names 1

• Audubon Villa Health and Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1366709289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 ISLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191533228",
            "telephone_number": "215-558-3700",
            "fax_number": "215-558-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S BROAD ST",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175431808",
            "telephone_number": "717-626-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT AUDUBON HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "MYZAL",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "215-558-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Audubon Villa Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Red Rose Emergency Physicians LLC
• Shawn M. Reed, RPH
• Rehabilitation Center at Brethren Village LLC
• Kim Reidenbaugh
• Leah Reider
• Corbin Reppert, OD
• Resolute Emergency Physicians, LLC
• Anne K. Rettig, M.D.
• Maria Reyes
• Richard M. Berg DDS, PC

• Skilled Nursing Facility in Lititz, PA
• Providers in Lititz, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.