| Organization Name: | 1 |
| NPI Number: | 1104246222 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VALERIE JANE WEIGAND (RN) |
| Mailing Address: | 14 Basswood Dr Mountain Top |
| State: | PA US |
| Postal Code: | 187071824 |
| Phone Number: | 5704740859 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2014 |
| NPI Last Update Date: | 04/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3140N1450X |
| License Number: | RN586725 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Skilled Nursing Facility |
| Taxonomy Specialization: | Nursing Care, Pediatric |
| Taxonomy Definition: | A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |