Home for the Aged of the Little Sisters of the Poor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

860302 Issued in PA

Legal business name

HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR

Doing business as

Holy Family Residence

Practice address

2500 Adams Ave
Scranton, PA 18509-1515

Phone

(570) 343-4065

Fax

(570) 343-8913

NPI assigned

Jul 11, 2005

Organization subpart

No

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

Authorized official

Name

Charles Patricia Mistretta, LSP

Title

Administrator

Phone

(570) 343-4065

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Holy Family Residence Doing business as

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1790783017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091515",
            "telephone_number": "570-343-4065",
            "fax_number": "570-343-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091515",
            "telephone_number": "570-343-4065",
            "fax_number": "570-343-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "MISTRETTA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-343-4065",
        "authorized_official_credential": "LSP"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "860302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007509960001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Family Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Scranton, PA
• Providers in Scranton, 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 Nov 13, 2009; 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.