Provider Demographics
NPI:1841175551
Name:MECHANICSBURG PA OPERATIONS LLC
Entity type:Organization
Organization Name:MECHANICSBURG PA OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-791-4705
Mailing Address - Street 1:2008 BLOOMFIELD CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6229
Mailing Address - Country:US
Mailing Address - Phone:718-791-4705
Mailing Address - Fax:
Practice Address - Street 1:707 SHEPHERDSTOWN RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4276
Practice Address - Country:US
Practice Address - Phone:718-791-4705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility