Op Hazelton, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

195202 Issued in PA

Legal business name

OP HAZELTON, LLC

Doing business as

The Manor at St. Luke Village

Practice address

1711 E Broad St
Hazleton, PA 18201-5691

Phone

(570) 453-5100

Fax

(570) 453-5138

NPI assigned

Jun 9, 2006

Last updated

Aug 22, 2020By 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

Joseph Conte

Title

Chief Operating Officer

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other names 1

• The Manor at St. Luke Village Doing business as

Locations

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760423065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CONCOURSE PKWY S",
            "address_2": "SUITE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516148",
            "telephone_number": "407-571-1550",
            "fax_number": "407-571-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015691",
            "telephone_number": "570-453-5100",
            "fax_number": "570-453-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OP HAZELTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONTE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "195202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Manor at St. Luke Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Hazleton, PA
• Providers in Hazleton, 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 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.