69 COTTAGE ROAD OPCO LLC
NPI 1922816966
Skilled Nursing Facility in Mifflin, PA

Active since December 23, 2024
69 COTTAGE RD, MIFFLIN, PA 17058(717) 436-8921(717) 436-9165 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 10, 2025, Feb 28, 2025, Dec 23, 2024 (3 updates tracked since 2024).

About 69 Cottage Road Opco Llc NPPES

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

69 COTTAGE ROAD OPCO LLC (NPI 1922816966), doing business as Locust Grove Retirement Village, is a healthcare organization registered as a skilled nursing facility in Mifflin, Pennsylvania and active in the NPI registry since December 2024. The organization lists Tiffany Hoback, Manager, as its authorized official.

NPPES Registry Identity

NPI1922816966
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name69 COTTAGE ROAD OPCO LLC
Location Address69 COTTAGE RDMifflin, PA 17058-7030
Mailing Address69 Cottage RdMifflin, PA 17058-7030 · (717) 436-8921 · Fax (717) 436-9165
Fax(717) 436-9165
Organization SubpartNo
Authorized OfficialTiffany HobackManager · (770) 698-9040
Enumeration DateDecember 23, 2024
Last NPPES UpdateMarch 10, 20253 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
NPI 1922816966 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.
69 COTTAGE RD, Mifflin, PA 17058

Other Names 1

Doing Business AsLocust Grove Retirement Village

Other Providers at the Same Location NPPES 9

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

Speech-Language Pathologist
69 COTTAGE RD
MIFFLIN, PA 17058
Physical Therapy Assistant
69 COTTAGE RD
MIFFLIN, PA 17058
Skilled Nursing Facility
69 COTTAGE RD
MIFFLIN, PA 17058
Occupational Therapy Assistant
69 COTTAGE RD
MIFFLIN, PA 17058
Physical Therapist
69 COTTAGE RD
MIFFLIN, PA 17058
Physical Therapy Assistant
69 COTTAGE RD
MIFFLIN, PA 17058
Speech-Language Pathologist
69 COTTAGE RD
MIFFLIN, PA 17058
Occupational Therapy Assistant
69 COTTAGE RD
MIFFLIN, PA 17058

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 69 Cottage Road Opco LLC's NPI number?

The NPI number for 69 Cottage Road Opco LLC is 1922816966. It was assigned to this organization in the NPPES registry on December 23, 2024. The provider is doing business as Locust Grove Retirement Village.

Where is 69 Cottage Road Opco LLC located?

69 Cottage Road Opco LLC is located at 69 Cottage Rd, Mifflin, PA 17058. The listed phone number is (717) 436-8921.

What is 69 Cottage Road Opco LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for 69 Cottage Road Opco LLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.