Provider Demographics
NPI:1003820689
Name:HOMESTEAD UNLIMITED, INC.
Entity Type:Organization
Organization Name:HOMESTEAD UNLIMITED, INC.
Other - Org Name:HOMESTEAD UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT-FINANCE, TREASURER &
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:UNVERFERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-999-2010
Mailing Address - Street 1:336 BLOOMFIELD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3271
Mailing Address - Country:US
Mailing Address - Phone:814-471-2877
Mailing Address - Fax:814-262-7415
Practice Address - Street 1:336 BLOOMFIELD ST STE 201
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3271
Practice Address - Country:US
Practice Address - Phone:814-471-2876
Practice Address - Fax:814-262-7415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101286872-0001Medicaid