Provider Demographics
NPI:1790758928
Name:CLARION FOREST VNA, INC
Entity Type:Organization
Organization Name:CLARION FOREST VNA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-297-8400
Mailing Address - Street 1:271 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8535
Mailing Address - Country:US
Mailing Address - Phone:814-297-8400
Mailing Address - Fax:814-297-8801
Practice Address - Street 1:271 PERKINS RD
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8535
Practice Address - Country:US
Practice Address - Phone:814-297-8400
Practice Address - Fax:814-297-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA711605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000095541OtherTHREE RIVERS MED
PA103977OtherUPMC
PA079219800OtherBLACK LUNG
PA0010815400001Medicaid
PA332758OtherADVANTRA
PA0754OtherBLUE CROSS VNA
PA2402OtherHEALTH AMER/HEALTH ASSURA
PA5556135OtherAETNA COMMERCIAL