Provider Demographics
NPI:1427337989
Name:GREAT COMMISSION CARE COMMUNITIES
Entity type:Organization
Organization Name:GREAT COMMISSION CARE COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:PCHA, NHA
Authorized Official - Phone:717-737-3373
Mailing Address - Street 1:824 LISBURN RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-7102
Mailing Address - Country:US
Mailing Address - Phone:717-737-3373
Mailing Address - Fax:717-737-3490
Practice Address - Street 1:824 LISBURN RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7102
Practice Address - Country:US
Practice Address - Phone:717-737-3373
Practice Address - Fax:717-737-3490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA339831311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)