Provider Demographics
NPI: | 1871820654 |
---|---|
Name: | FRIENDSHIP COMMUNITY |
Entity type: | Organization |
Organization Name: | FRIENDSHIP COMMUNITY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR OF FINANCE |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MYRON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | STONER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 717-656-2466 |
Mailing Address - Street 1: | 1149 E OREGON RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LITITZ |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17543-8366 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-656-2466 |
Mailing Address - Fax: | 717-656-0459 |
Practice Address - Street 1: | 1159 E OREGON RD |
Practice Address - Street 2: | |
Practice Address - City: | LITITZ |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17543-8366 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-656-2466 |
Practice Address - Fax: | 717-656-0459 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-11-16 |
Last Update Date: | 2009-11-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | 315P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities |