MANOR AT SUSQUEHANNA VILLAGE
NPI 1669496287
Skilled Nursing Facility in Millersburg, PA

Active since July 27, 2006CLIA 39D0904034 · Waiver
990 MEDICAL RD, MILLERSBURG, PA 17061(717) 692-4751(717) 692-4588 Get Directions Write a Review

NPPES record last updated: July 7, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Manor At Susquehanna Village NPPES

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

MANOR AT SUSQUEHANNA VILLAGE (NPI 1669496287) is a healthcare organization registered as a skilled nursing facility in Millersburg, Pennsylvania and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 3, 2027 and lists Kenneth Ussery, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1669496287
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSUSQUEHANNA VILLAGE FACILITY OPERATIONS, LLC
Location Address990 MEDICAL RDMillersburg, PA 17061-1235
Mailing Address800 Concourse Pkwy S, Suite 200Maitland, FL 32751-6148 · (407) 571-1550 · Fax (407) 571-1599
Fax(717) 692-4588
Organization SubpartNo
Authorized OfficialKenneth UsseryAuthorized Official · (407) 571-1550
Enumeration DateJuly 27, 2006
Last NPPES UpdateJuly 7, 2017
NPI 1669496287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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

Other Names 1

Doing Business AsManor At Susquehanna Village

Other Identifiers 3

Medicare PIN39-5428
Medicare NSC5917560001
Medicaid1018126480001PA

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 Phone
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.

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

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 Susquehanna Village Facility Operations, LLC's NPI number?

The NPI number for Susquehanna Village Facility Operations, LLC is 1669496287. It was assigned to this organization in the NPPES registry on July 27, 2006. The provider is doing business as Manor At Susquehanna Village.

Where is Susquehanna Village Facility Operations, LLC located?

Susquehanna Village Facility Operations, LLC is located at 990 Medical Rd, Millersburg, PA 17061. The listed phone number is (717) 692-4751.

What is Susquehanna Village Facility Operations, LLC's specialty?

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

Does Susquehanna Village Facility Operations, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0904034) is associated with this NPI, valid through August 3, 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 Susquehanna Village Facility Operations, LLC was last updated on July 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.