Provider Demographics
NPI:1801368691
Name:GAUNLEY HOME CARE LLC
Entity Type:Organization
Organization Name:GAUNLEY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BIRAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADHIKARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-515-9723
Mailing Address - Street 1:720 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-1837
Mailing Address - Country:US
Mailing Address - Phone:570-800-7907
Mailing Address - Fax:570-800-7907
Practice Address - Street 1:720 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1837
Practice Address - Country:US
Practice Address - Phone:570-800-7907
Practice Address - Fax:570-800-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103366005-1000Medicaid