Provider Demographics
NPI:1710354402
Name:EMERALD SENIOR SERVICES D/B/A IN HOME HEALTH CARE FOR ELDERLY
Entity Type:Organization
Organization Name:EMERALD SENIOR SERVICES D/B/A IN HOME HEALTH CARE FOR ELDERLY
Other - Org Name:EMERALD SENIOR SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT DIRECTOR OF SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLARIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-944-4712
Mailing Address - Street 1:532 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-1947
Mailing Address - Country:US
Mailing Address - Phone:717-944-4712
Mailing Address - Fax:717-944-4527
Practice Address - Street 1:532 N SPRING ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-1947
Practice Address - Country:US
Practice Address - Phone:717-944-4712
Practice Address - Fax:717-944-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15403601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health