NPI 1174901375

The Lutheran Home for the Aged D/B/A the Village at Luther Square

Organisation Skilled Nursing Facility Erie, PA

Practice location

Address: 149 W 22nd St, Erie, PA 16502-2804
Phone: (814) 456-5433
Fax: (814) 456-0383

Authorised official

Name: Bradley P Fox
Title: Medical Director
Phone: (814) 456-5433

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 314000000X (PA)

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Registry record

NPI: 1174901375
Entity type: Organization
NPI issued: 8 May 2015
Record last updated: 8 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.