Provider Demographics
NPI:1083784219
Name:SOUTHEASTERN HOME HEALTH SERVICES OF PA, LLC
Entity Type:Organization
Organization Name:SOUTHEASTERN HOME HEALTH SERVICES OF PA, LLC
Other - Org Name:ACCENTCARE HOME HEALTH OF CENTRAL PENNSYLVANIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP LEGAL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SISCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-367-2571
Mailing Address - Street 1:1501 GRUNDY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-1506
Mailing Address - Country:US
Mailing Address - Phone:215-826-0900
Mailing Address - Fax:215-826-8300
Practice Address - Street 1:278 MAYTOWN RD STE 400
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-9313
Practice Address - Country:US
Practice Address - Phone:717-367-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019152980001Medicaid
PA398062Medicare Oscar/Certification