Provider Demographics
NPI:1710230255
Name:HOMEWELL SENIOR CARE-WESTMORELAND COUNTY
Entity Type:Organization
Organization Name:HOMEWELL SENIOR CARE-WESTMORELAND COUNTY
Other - Org Name:HOMEWELL SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-635-0767
Mailing Address - Street 1:4 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-8202
Mailing Address - Country:US
Mailing Address - Phone:724-635-0767
Mailing Address - Fax:724-635-0770
Practice Address - Street 1:4 S 4TH ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-8202
Practice Address - Country:US
Practice Address - Phone:724-635-0767
Practice Address - Fax:724-635-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16183601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care