Carleton Senior Care and Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CARLETON SENIOR CARE AND REHABILITATION CENTER LLC

Doing business as

Carleton Healthcare and Rehabilitation Center

Practice address

10 West Ave
Wellsboro, PA 16901-1325

Phone

(570) 724-2631

NPI assigned

May 5, 2006

Last updated

Aug 25, 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

Michael Eperesi

Title

Cfo

Phone

(814) 265-1164

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Carleton Healthcare and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1992753495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8796 ROUTE 219",
            "city": "BROCKWAY",
            "state": "PA",
            "postal_code": "158246010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WEST AVE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011325",
            "telephone_number": "570-724-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLETON SENIOR CARE AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "EPERESI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-265-1164"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "080802",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001800180-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carleton Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carleton Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Kandra Butters, MS, OTR/L
• David M Cahill, MD
• Ronald Wayne Callenberger, MD
• Edward Jeffrey Candela, DDS
• Douglas Candelario, LPC
• Casey Loren Carpenter, PTA
• Amy Chalot
• William Douglas Chancellor, LCSW
• Barry A Clark, MD
• Mary Catherine Clark, MS, BSL, BSC, MT

• Skilled Nursing Facility in Wellsboro, PA
• Providers in Wellsboro, 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 25, 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.