Provider Demographics
NPI:1093119182
Name:NEPA HOMECARE INC
Entity Type:Organization
Organization Name:NEPA HOMECARE INC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-814-9053
Mailing Address - Street 1:2200 STAFFORD AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3708
Mailing Address - Country:US
Mailing Address - Phone:570-866-2532
Mailing Address - Fax:570-270-6706
Practice Address - Street 1:920 WYOMING AVE STE 102
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-3970
Practice Address - Country:US
Practice Address - Phone:570-270-6700
Practice Address - Fax:570-270-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA14333601253Z00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102117103Medicaid