Provider Demographics
NPI:1689113276
Name:GREAT AMERICAN HOME CARE LTD
Entity Type:Organization
Organization Name:GREAT AMERICAN HOME CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GUZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:814-881-6623
Mailing Address - Street 1:10032 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-5556
Mailing Address - Country:US
Mailing Address - Phone:814-725-3245
Mailing Address - Fax:814-725-3245
Practice Address - Street 1:10032 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-5556
Practice Address - Country:US
Practice Address - Phone:814-725-3245
Practice Address - Fax:814-725-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30943601302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization