Provider Demographics
NPI:1790395325
Name:FOREVER YOURS HOME CARE STAFFING AGENCY LLC
Entity Type:Organization
Organization Name:FOREVER YOURS HOME CARE STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:570-433-1384
Mailing Address - Street 1:1419 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-4432
Mailing Address - Country:US
Mailing Address - Phone:570-433-1384
Mailing Address - Fax:
Practice Address - Street 1:1419 SCOTT ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-4432
Practice Address - Country:US
Practice Address - Phone:157-047-8433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care