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CHRIST THE KING MANOR
NPI 1164878070
In Home Supportive Care in Du Bois, PA

Active since May 10, 2016CLIA 39D0899548 · Waiver
1100 W LONG AVE, DU BOIS, PA 15801(814) 371-3180(814) 371-4101 Get Directions Write a Review

NPPES record last updated: February 24, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 24, 2020, May 10, 2016 (2 updates tracked since 2016).

About Christ The King Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHRIST THE KING MANOR (NPI 1164878070) is a healthcare organization registered as an in home supportive care in Du Bois, Pennsylvania and active in the NPI registry since May 2016. The organization holds a CLIA Waiver certificate valid through April 2, 2027 and lists Edward A Andrulonis, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1164878070
Entity TypeOrganization
Primary Taxonomy253Z00000X
Legal Business NameCHRIST THE KING MANOR
Location Address1100 W LONG AVEDu Bois, PA 15801-3986
Mailing Address1100 W Long AveDu Bois, PA 15801-3986 · (814) 371-3180 · Fax (814) 371-4101
Phone(814) 371-3180
Fax(814) 371-4101
Organization SubpartNo
Authorized OfficialEdward A AndrulonisChief Operating Officer · (814) 371-3180
Enumeration DateMay 10, 2016
Last NPPES UpdateFebruary 24, 20202 updates tracked since enumeration
✔ NPI 1164878070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIn Home Supportive CareAgencies
Taxonomy Code253Z00000X
License✔ Licensed in PA · 18633601
Definition

An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

1100 W LONG AVE, Du Bois, PA 15801
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Other Identifiers 1

Medicaid1316063324PA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0899548

Christ The King Manor · Dubois, PA
Active · expires Apr 2, 2027
CLIA Number39D0899548
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorDr. Eric Peck
Laboratory Phone(814) 371-3180
Laboratory LocationChrist The King Manor1100 West Long Avenue, Dubois, PA 15801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTIN R MALONEY PT
Physical Therapist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
JESSICA LYNN KALMAR SLP
Speech-Language Pathologist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (724) 448-5697
MADISON H JOHNSON
Occupational Therapy Assistant
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
MISS KAYLA MARIE SHAFFER COTA
Occupational Therapy Assistant
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
MEGAN LINDERMAN PT, DPT
Physical Therapist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
CASSANDRA MARIE LEWIS OTD, OTR/L
Occupational Therapist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
PAIGE KERIN
Speech-Language Pathologist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180
DALTON MEALS
Speech-Language Pathologist
1100 W LONG AVE
DU BOIS, PA 15801
Clearfield County (814) 371-3180

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Christ The King Manor's NPI number?

The NPI number for Christ The King Manor is 1164878070. It was assigned to this organization in the NPPES registry on May 10, 2016.

Where is Christ The King Manor located?

Christ The King Manor is located at 1100 W Long Ave, Du Bois, PA 15801. The listed phone number is (814) 371-3180.

What is Christ The King Manor's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

Does Christ The King Manor hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0899548) is associated with this NPI, valid through April 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Christ The King Manor was last updated on February 24, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.