Provider Demographics
NPI:1093950164
Name:HARGAR SUPREME CARE AND STAFFING, INC.
Entity Type:Organization
Organization Name:HARGAR SUPREME CARE AND STAFFING, INC.
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL PROGRAM
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SADDY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:610-237-7467
Mailing Address - Street 1:237 WOLFENDEN AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3221
Mailing Address - Country:US
Mailing Address - Phone:610-237-7467
Mailing Address - Fax:610-237-7468
Practice Address - Street 1:237 WOLFENDEN AVE
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3221
Practice Address - Country:US
Practice Address - Phone:610-237-7467
Practice Address - Fax:610-237-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child