Ggnsc Warren Kinzua Valley LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

071402 Issued in PA

Legal business name

GGNSC WARREN KINZUA VALLEY LP

Doing business as

Golden LivingCenter - Kinzua

Practice address

205 Water St
Warren, PA 16365-2307

Phone

(814) 726-0820

Fax

(814) 726-9717

NPI assigned

May 12, 2006

Last updated

Jul 16, 2014By 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

Holly A. Rasmussen-Jones

Title

Sec. of the GP

Phone

(479) 201-4835

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Golden LivingCenter - Kinzua Doing business as

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1982655189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WATER ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652307",
            "telephone_number": "814-726-0820",
            "fax_number": "814-726-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WATER ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652307",
            "telephone_number": "814-726-0820",
            "fax_number": "814-726-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GGNSC WARREN KINZUA VALLEY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN-JONES",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SEC. OF THE GP",
        "authorized_official_telephone_number": "479-201-4835"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "071402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS HEALTH PLAN",
            "identifier": "000000092721",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015495990001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00833349",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1523922",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101549599",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "410362",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "126207",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden LivingCenter - Kinzua",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Warren, PA
• Providers in Warren, 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 Jul 16, 2014; 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.