Provider Demographics
NPI:1265435952
Name:ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.
Entity type:Organization
Organization Name:ALLEGHENY LUTHERAN SOCIAL MINISTRIES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NHA
Authorized Official - Phone:814-696-4518
Mailing Address - Street 1:916 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2248
Mailing Address - Country:US
Mailing Address - Phone:814-696-4500
Mailing Address - Fax:814-696-4561
Practice Address - Street 1:915 HICKORY ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2247
Practice Address - Country:US
Practice Address - Phone:814-696-4500
Practice Address - Fax:814-696-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10502314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0635OtherBLUE CROSS
PA1001998070016Medicaid
PA1001998070016Medicaid
PA395427Medicare ID - Type Unspecified
PA1001998070016Medicaid