CHRIST THE KING MANOR NPI 1164878070

NPI Information

  • NPI: 1164878070
  • Provider Name: CHRIST THE KING MANOR
  • Classification: In Home Supportive Care - 253Z00000X
  • Entity Type: Organization
  • CLIA Number: 39D0899548
  • Address: 1100 W LONG AVE
    DU BOIS, PA
    ZIP 15801
  • Phone: (814) 371-3180

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NPI Details

CHRIST THE KING MANOR is an in home supportive care in Du Bois, PA. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. CHRIST THE KING MANOR NPI is 1164878070. The provider is registered as an organization entity type.

The provider's business location address is:

1100 W LONG AVE
DU BOIS, PA
ZIP 15801-986
Phone: (814) 371-3180
Fax: (814) 371-4101

The provider's authorized official is Edward A Andrulonis .
The authorized official title is Chief Operating Officer and has the following contact phone number (814) 371-3180.

The CLIA number assigned to this NPI record is 39D0899548 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2016 and was last updated on 2/24/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive Care18633601PENNSYLVANIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11316063324MEDICAIDPENNSYLVANIA

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: 11/21/2025

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