Oak HRC Broad Mountain LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OAK HRC BROAD MOUNTAIN LLC

Practice address

500 W Laurel St
Frackville, PA 17931-2018

Phone

(570) 874-0696

NPI assigned

Jan 23, 2015

Organization subpart

Yes

Parent organization

OAK HEALTH AND REHABILITATION CENTERS INC.As reported in NPPES

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

Authorized official

Name

Howard Jaffe

Title

Officer

Phone

(215) 346-6454

Specialties & licenses 1

Addresses

Other names 1

• Broad Mountain Health and Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1851781249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W LAUREL ST",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179312018",
            "telephone_number": "570-874-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W LAUREL ST",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179312018",
            "telephone_number": "570-874-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK HRC BROAD MOUNTAIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAK HEALTH AND REHABILITATION CENTERS INC.",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "215-346-6454"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad Mountain Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megen Michael
• Hannah Elizabeth Nestor, DPT
• Northern Health Facilities, Inc.
• Casey D. Nowak, DO
• Brian Michael O'Connell, DPT
• Debra L. Papp, CRNP
• David Dean Paul, DDS
• Amanda Pavalko, MS, CCC/SLP
• Phoenix Rehabilitation and Health Services, Inc.
• Sheila Elizabeth Purcell, MSOTRL

• Skilled Nursing Facility in Frackville, PA
• Providers in Frackville, 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 Jan 23, 2015; 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.