Provider Demographics
NPI:1346696614
Name:HOME NURSING AGENCY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:HOME NURSING AGENCY COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:814-946-5411
Mailing Address - Street 1:201 CHESTNUT AVE
Mailing Address - Street 2:PO BOX 352
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4927
Mailing Address - Country:US
Mailing Address - Phone:814-946-5411
Mailing Address - Fax:814-940-8471
Practice Address - Street 1:201 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4927
Practice Address - Country:US
Practice Address - Phone:814-941-1389
Practice Address - Fax:814-940-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15283601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000007650070Medicaid