Provider Demographics
NPI:1770820920
Name:HOUCK CARE AND CLEANING
Entity Type:Organization
Organization Name:HOUCK CARE AND CLEANING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-571-4544
Mailing Address - Street 1:19 COLONNADE WAY
Mailing Address - Street 2:STE 117, PMB 291
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2319
Mailing Address - Country:US
Mailing Address - Phone:814-571-4544
Mailing Address - Fax:
Practice Address - Street 1:2738 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2646
Practice Address - Country:US
Practice Address - Phone:814-571-4544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11443601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health