Provider Demographics
NPI:1093702938
Name:CENTRE HOMECARE, INC.
Entity Type:Organization
Organization Name:CENTRE HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:M ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-237-7400
Mailing Address - Street 1:2437 COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7454
Mailing Address - Country:US
Mailing Address - Phone:814-237-7400
Mailing Address - Fax:814-237-2900
Practice Address - Street 1:2437 COMMERCIAL BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7454
Practice Address - Country:US
Practice Address - Phone:814-237-7400
Practice Address - Fax:814-237-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA712605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397126Medicare ID - Type Unspecified