Provider Demographics
NPI:1275853673
Name:CENTRAL PENNSYLVANIA HOMECARE, LLC
Entity Type:Organization
Organization Name:CENTRAL PENNSYLVANIA HOMECARE, LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR MBR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASNANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-238-8820
Mailing Address - Street 1:2100 E COLLEGE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7269
Mailing Address - Country:US
Mailing Address - Phone:814-238-8820
Mailing Address - Fax:814-238-8870
Practice Address - Street 1:2100 E COLLEGE AVE STE B
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7269
Practice Address - Country:US
Practice Address - Phone:814-238-8820
Practice Address - Fax:814-238-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11213601253Z00000X
PA12083601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001921087-0001Medicaid