OrganizationActive
Pennsylvania Department of Human Services
NPI 1760465454 · Intellectual Disabilities Intermediate Care Facility · White Haven, PA
Provider details
- NPI number
- 1760465454
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Kathy Light, Administrator
Practice location
827 Oley Valley Rd
White Haven, PA 18661-3043
Phone: (570) 443-4266
Fax: (570) 443-4263
Mailing address
827 Oley Valley Rd
White Haven, PA 18661-3043
Registry dates
- Enumerated
- 2005-11-28
- Last updated
- 2021-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.