Provider Demographics
NPI:1285321885
Name:SUGAR VALLEY LODGE INC
Entity type:Organization
Organization Name:SUGAR VALLEY LODGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-346-0352
Mailing Address - Street 1:190 SUGAR VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-5201
Mailing Address - Country:US
Mailing Address - Phone:814-346-0352
Mailing Address - Fax:814-346-0354
Practice Address - Street 1:190 SUGAR VALLEY LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-5201
Practice Address - Country:US
Practice Address - Phone:814-346-0352
Practice Address - Fax:814-346-0354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility