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ST MARY'S HOME OF ERIE NPI 1437190907


NPI Information

NPI: 1437190907
Provider Name: ST MARY'S HOME OF ERIE

Doing Business As: SAINT MARY'S AT ASBURY RIDGE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 39D2004360

Address:
4855 W RIDGE RD
ERIE, PA
ZIP 16506
Phone: (814) 836-5300
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ST MARY'S HOME OF ERIE is an assisted living facility in Erie, PA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. ST MARY'S HOME OF ERIE NPI is 1437190907. The provider is registered as an organization entity type.
The provider Is Doing Business As Saint Mary's At Asbury Ridge.

The provider's business location address is:

4855 W RIDGE RD
ERIE, PA
ZIP 16506-213
Phone: (814) 836-5300
Fax: (814) 451-1394

The provider's authorized official is Audrey Urban .
The authorized official title is Administration and has the following contact phone number (814) 836-5305.

The CLIA number assigned to this NPI record is 39D2004360 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility413420PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11007457470003MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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