Provider Demographics
NPI:1366034357
Name:AMP HOME CARE
Entity Type:Organization
Organization Name:AMP HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-350-8349
Mailing Address - Street 1:4185 IVANHOE DR APT 316
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2628
Mailing Address - Country:US
Mailing Address - Phone:412-371-8763
Mailing Address - Fax:
Practice Address - Street 1:1916 LAKETON RD FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-1206
Practice Address - Country:US
Practice Address - Phone:412-242-0246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health