Provider Demographics
NPI:1720372238
Name:KNABE, TWO SISTER'S HOMES LLC
Entity Type:Organization
Organization Name:KNABE, TWO SISTER'S HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-855-0098
Mailing Address - Street 1:739 COHASSET DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-1465
Mailing Address - Country:US
Mailing Address - Phone:234-855-0098
Mailing Address - Fax:330-747-3491
Practice Address - Street 1:739 COHASSET DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-1465
Practice Address - Country:US
Practice Address - Phone:234-855-0098
Practice Address - Fax:330-747-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5010151163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHM5000868Medicaid
OHM5000868Medicare PIN