Provider Demographics
NPI:1730450479
Name:WILLOW VALLEY RETIREMENT COMMUNITIES
Entity type:Organization
Organization Name:WILLOW VALLEY RETIREMENT COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GREIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-464-2741
Mailing Address - Street 1:600 WILLOW VALLEY SQ
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4866
Mailing Address - Country:US
Mailing Address - Phone:717-464-6411
Mailing Address - Fax:717-464-6040
Practice Address - Street 1:600 WILLOW VALLEY SQ
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4866
Practice Address - Country:US
Practice Address - Phone:717-464-6411
Practice Address - Fax:717-464-6040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLOW VALLEY COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-25
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD00994OtherSTATE DEPARTMENT OF HEALTH