Provider Demographics
NPI:1578893186
Name:HARRISBURG HOME HEALTH HOLDINGS, LLC
Entity Type:Organization
Organization Name:HARRISBURG HOME HEALTH HOLDINGS, LLC
Other - Org Name:HOME REMEDY SKILLED NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-715-8700
Mailing Address - Street 1:4813 JONESTOWN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1749
Mailing Address - Country:US
Mailing Address - Phone:717-715-8700
Mailing Address - Fax:717-715-8704
Practice Address - Street 1:4813 JONESTOWN RD STE 201
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1749
Practice Address - Country:US
Practice Address - Phone:717-715-8700
Practice Address - Fax:717-715-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03580501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024538120001Medicaid