Provider Demographics
NPI:1053511931
Name:DIAKON LUTHERAN SOCIAL MINISTRIES
Entity Type:Organization
Organization Name:DIAKON LUTHERAN SOCIAL MINISTRIES
Other - Org Name:DIAKON HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-795-0388
Mailing Address - Street 1:416 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1839
Mailing Address - Country:US
Mailing Address - Phone:570-251-8712
Mailing Address - Fax:570-251-8716
Practice Address - Street 1:416 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1839
Practice Address - Country:US
Practice Address - Phone:570-251-8712
Practice Address - Fax:570-251-8716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02340501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health