Integrated Health of Locust Valley Road, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

092002 Issued in PA

Legal business name

INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.

Practice address

890 Weatherwood LN
Greensburg, PA 15601-5777

Phone

(305) 892-1790

Fax

(305) 538-2699

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Theodore M Duay III, CPA

Title

Cfo

Phone

(305) 892-1790

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• IHS of Greater Pittsburgh Other name

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689889701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MICHIGAN AVE",
            "address_2": "SUITE 736",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392538",
            "telephone_number": "305-892-1790",
            "fax_number": "305-538-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 WEATHERWOOD LN",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015777",
            "telephone_number": "305-892-1790",
            "fax_number": "305-538-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH OF LOCUST VALLEY ROAD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUAY",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-892-1790",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "PA",
            "license": "092002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007393380002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHS of Greater Pittsburgh",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Providers in Greensburg, 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 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.