MANOR AT SUSQUEHANNA
NPI 1629317219
Skilled Nursing Facility in Millersburg, PA

Active since February 03, 2013CLIA 39D0904034 · Waiver
990 MEDICAL RD, MILLERSBURG, PA 17061(717) 692-5209 Get Directions Write a Review

NPPES record last updated: February 3, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Manor At Susquehanna NPPES

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

MANOR AT SUSQUEHANNA (NPI 1629317219) is a healthcare organization registered as a skilled nursing facility in Millersburg, Pennsylvania and active in the NPI registry since February 2013. The organization holds a CLIA Waiver certificate valid through August 3, 2027 and lists Deborah D. Troutman, Physical Therapist Assistant, as its authorized official.

NPPES Registry Identity

NPI1629317219
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMANOR AT SUSQUEHANNA
Location Address990 MEDICAL RDMillersburg, PA 17061-1235
Mailing Address6003 Sommerton DrMechanicsburg, PA 17050-7374 · (717) 612-1980
Organization SubpartNo
Authorized OfficialDeborah D. TroutmanPhysical Therapist Assistant · (717) 692-5209
Enumeration DateFebruary 3, 2013
NPI 1629317219 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 · TE1000673
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.

990 MEDICAL RD, Millersburg, PA 17061

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 39D0904034

Manor At Susquehanna Village, The · Millersburg, PA
Active · expires Aug 3, 2027
CLIA Number39D0904034
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateAugust 4, 2025
Certificate Expiration DateAugust 3, 2027
Laboratory DirectorRobert A. Ettlinger MD
Laboratory Phone(717) 692-4751
Laboratory LocationManor At Susquehanna Village, The990 Medical Road, Millersburg, PA 17061
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

Occupational Therapy Assistant
990 MEDICAL RD
MILLERSBURG, PA 17061
Speech-Language Pathologist
990 MEDICAL RD
MILLERSBURG, PA 17061
Occupational Therapy Assistant
990 MEDICAL RD
MILLERSBURG, PA 17061
Physical Therapy Assistant
990 MEDICAL RD
MILLERSBURG, PA 17061
Skilled Nursing Facility
990 MEDICAL RD
MILLERSBURG, PA 17061
Skilled Nursing Facility
990 MEDICAL RD
MILLERSBURG, PA 17061
Physical Therapist
990 MEDICAL RD
MILLERSBURG, PA 17061

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629317219, enumerated as an "organization" on February 03, 2013.

The provider is located at 990 MEDICAL RD MILLERSBURG, PA 17061 and the phone number is (717) 692-5209.

Skilled Nursing Facility with taxonomy code 314000000X.