LOCUST GROVE RETIREMENT VILLAGE
NPI 1235171810
Skilled Nursing Facility in Mifflin, PA

Active since June 11, 2006CLIA 39D0886113 · Waiver
HC 67, BOX 7, MIFFLIN, PA 17058(717) 436-8921(717) 436-9165 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Locust Grove Retirement Village NPPES

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

LOCUST GROVE RETIREMENT VILLAGE (NPI 1235171810) is a healthcare organization registered as a skilled nursing facility in Mifflin, Pennsylvania and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through May 12, 2028 and lists Joseph Conte, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1235171810
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameOP MIFFLIN, LLC
Location AddressHC 67, BOX 7Mifflin, PA 17058-9801
Mailing Address800 Concourse Pkwy S, Suite 200Maitland, FL 32751-6148 · (407) 571-1550 · Fax (407) 571-1599
Fax(717) 436-9165
Organization SubpartNo
Authorized OfficialJoseph ConteChief Operating Officer · (407) 571-1550
Enumeration DateJune 11, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1235171810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in PA · 123402
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
HC 67, Mifflin, PA 17058

Other Names 1

Doing Business AsLocust Grove Retirement Village

Other Identifiers 1

Medicaid1012263640001PA

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 39D0886113

Locust Grove Retirement Village · Mifflin, PA
Active · expires May 12, 2028
CLIA Number39D0886113
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMay 13, 2026
Certificate Expiration DateMay 12, 2028
Laboratory DirectorDr. Brandon M. Roscoe
Laboratory Phone(717) 436-8921
Laboratory LocationLocust Grove Retirement Village69 Cottage Road, Mifflin, PA 17058
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Op Mifflin, LLC's NPI number?

The NPI number for Op Mifflin, LLC is 1235171810. It was assigned to this organization in the NPPES registry on June 11, 2006. The provider is doing business as Locust Grove Retirement Village.

Where is Op Mifflin, LLC located?

Op Mifflin, LLC is located at Hc 67 Box 7, Mifflin, PA 17058. The listed phone number is (717) 436-8921.

What is Op Mifflin, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Op Mifflin, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0886113) is associated with this NPI, valid through May 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Op Mifflin, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.