Provider Demographics
NPI:1235136805
Name:HOME HEALTH CARE PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:HOME HEALTH CARE PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-650-9763
Mailing Address - Street 1:520 BURKE BYP
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-1805
Mailing Address - Country:US
Mailing Address - Phone:570-876-2900
Mailing Address - Fax:570-382-3568
Practice Address - Street 1:520 BURKE BYP
Practice Address - Street 2:
Practice Address - City:OLYPHANT
Practice Address - State:PA
Practice Address - Zip Code:18447-1805
Practice Address - Country:US
Practice Address - Phone:570-876-2900
Practice Address - Fax:570-382-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39Q7662001251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01582492Medicaid
PA001582492Medicaid
PA397662Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
397662Medicare Oscar/Certification