Provider Demographics
NPI:1023203429
Name:THE GOOD SHEPHERD HOME HEALTH CARE AND HOSPICE
Entity Type:Organization
Organization Name:THE GOOD SHEPHERD HOME HEALTH CARE AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-785-2342
Mailing Address - Street 1:2215 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-4430
Mailing Address - Country:US
Mailing Address - Phone:215-785-2342
Mailing Address - Fax:215-785-2356
Practice Address - Street 1:2215 WILSON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-4430
Practice Address - Country:US
Practice Address - Phone:215-785-2342
Practice Address - Fax:215-785-2356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-09
Last Update Date:2007-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care