Provider Demographics
NPI:1235990169
Name:1 LAUREL HIGHLANDS HOSPICE, LLC
Entity Type:Organization
Organization Name:1 LAUREL HIGHLANDS HOSPICE, LLC
Other - Org Name:1 LAUREL HIGHLANDS HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-410-9119
Mailing Address - Street 1:970 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4107
Mailing Address - Country:US
Mailing Address - Phone:814-248-3004
Mailing Address - Fax:
Practice Address - Street 1:970 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4107
Practice Address - Country:US
Practice Address - Phone:814-410-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based