OrganizationActive
1711 East Broad Street Opco LLC
NPI 1356159206 · Skilled Nursing Facility · Hazleton, PA
Provider details
- NPI number
- 1356159206
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Tiffany Hoback, Manager(770) 698-9040
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1711 E Broad St
Hazleton, PA 18201-5691
Phone: (570) 453-5100
Fax: (570) 453-5138
Approximate (ZIP-level) locationGet directions
Mailing address
1711 E Broad St
Hazleton, PA 18201-5691
Other names (DBA / former)
- Doing business as
- The Manor at St. Luke Village
Registry dates
- Enumerated
- 2024-12-24
- Last updated
- 2025-03-10
- Certified
- 2025-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.