Provider Demographics
NPI:1083800171
Name:WIMERT HOME I
Entity Type:Organization
Organization Name:WIMERT HOME I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:WIMERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-222-6922
Mailing Address - Street 1:550 FAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5517
Mailing Address - Country:US
Mailing Address - Phone:724-222-6922
Mailing Address - Fax:724-222-7366
Practice Address - Street 1:550 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5517
Practice Address - Country:US
Practice Address - Phone:724-222-6922
Practice Address - Fax:724-222-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility