Provider Demographics
NPI:1235100751
Name:HOMEMAKERS OF WESTERN PENNA, INC.
Entity Type:Organization
Organization Name:HOMEMAKERS OF WESTERN PENNA, INC.
Other - Org Name:CAREGIVERS HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP&CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FLITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-838-6060
Mailing Address - Street 1:2465 SHERIDAN DR
Mailing Address - Street 2:C/O HOMEMAKERS UPSTATE GROUP, INC.
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-9407
Mailing Address - Country:US
Mailing Address - Phone:716-838-6060
Mailing Address - Fax:716-838-2913
Practice Address - Street 1:2820 W 23RD ST
Practice Address - Street 2:SUITE #8 EBCO PARK
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2915
Practice Address - Country:US
Practice Address - Phone:814-838-8696
Practice Address - Fax:814-835-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA003105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100732829003Medicaid
PA1244OtherHIGHMARK BLUE CROSS
PA397760Medicare ID - Type UnspecifiedMEDICARE NUMBER