Provider Demographics
NPI:1245584713
Name:JRFAYASH, INC
Entity Type:Organization
Organization Name:JRFAYASH, INC
Other - Org Name:CARING SENIOR SERVICE OF STROUDSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FAYASH
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:570-234-3892
Mailing Address - Street 1:421 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NESQUEHONING
Mailing Address - State:PA
Mailing Address - Zip Code:18240-2418
Mailing Address - Country:US
Mailing Address - Phone:570-634-9306
Mailing Address - Fax:
Practice Address - Street 1:2525 ROUTE 115
Practice Address - Street 2:
Practice Address - City:EFFORT
Practice Address - State:PA
Practice Address - Zip Code:18330-9520
Practice Address - Country:US
Practice Address - Phone:570-234-3892
Practice Address - Fax:866-950-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21803601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care