Provider Demographics
NPI:1376800946
Name:CARLSON ENTERPRISES, LLC
Entity Type:Organization
Organization Name:CARLSON ENTERPRISES, LLC
Other - Org Name:ASSISTING HANDS OF COLLEGEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-539-0520
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19408-0246
Mailing Address - Country:US
Mailing Address - Phone:610-539-0520
Mailing Address - Fax:610-630-0207
Practice Address - Street 1:3118 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1005
Practice Address - Country:US
Practice Address - Phone:610-539-0520
Practice Address - Fax:610-630-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA19393601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health