Lutheran Home for the Aged

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

382602 Issued in PA

Legal business name

LUTHERAN HOME FOR THE AGED

Doing business as

The Village at Luther Square

Practice address

149 W 22ND St
Erie, PA 16502-2804

Phone

(814) 452-3271

Fax

(814) 456-0383

NPI assigned

Jun 30, 2005

Last updated

Jan 3, 2011By 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

Mr. Mark J. Gusek

Title

C Eo

Phone

(814) 452-3271

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Village at Luther Square Doing business as

Tax ID family

Life-Northwestern Pennsylvania3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Life-Northwestern Pennsylvania

  • PACE Provider Organization
  • Erie, PA
  • NPI 1891980355
  NPD tax ID
• The Lutheran Home for the Aged D/B/a the Village at Luther Square

  • Skilled Nursing Facility
  • Erie, PA
  • NPI 1174901375
  NPD tax ID

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1891792354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 W 22ND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022804",
            "telephone_number": "814-452-3271",
            "fax_number": "814-456-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 W 22ND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022804",
            "telephone_number": "814-452-3271",
            "fax_number": "814-456-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "GUSEK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "C EO",
        "authorized_official_telephone_number": "814-452-3271",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "382602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO.",
            "identifier": "0648",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007767250002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Luther Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Lupo
• Robert A Lupo, MD
• Thomas Lupp II
• Melissa K Lustic-Long, RDN, ATC, CSCS
• Suzanne Luteran, CNP-FAMILY
• Sandra L Luthringer, R.D.,L.D.N
• Stacey J Lutz-McCain, CRNP
• Luxottica of America Inc (Target Optical #C4127)
• Luxottica of America Inc. (LensCrafters #159)
• Luxottica Retail North America Inc (Sears Optical #0529)

• Skilled Nursing Facility in Erie, PA
• Providers in Erie, 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 3, 2011; 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.