Provider Demographics
NPI:1154325918
Name:COMPLETE HOME CARE, INC
Entity Type:Organization
Organization Name:COMPLETE HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADM
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUFTA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:570-287-4711
Mailing Address - Street 1:335 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5147
Mailing Address - Country:US
Mailing Address - Phone:570-287-4711
Mailing Address - Fax:570-287-4438
Practice Address - Street 1:335 PIERCE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5147
Practice Address - Country:US
Practice Address - Phone:570-287-4711
Practice Address - Fax:570-287-4438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA740705251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA073277OtherFIRST PRIORITY
PA397407OtherBLUE CROSS
PA001166352Medicaid
PA397407BMedicare ID - Type Unspecified