Provider Demographics
NPI:1821446618
Name:STATCARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:STATCARE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-782-8300
Mailing Address - Street 1:4421 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-1505
Mailing Address - Country:US
Mailing Address - Phone:844-782-8300
Mailing Address - Fax:844-782-8301
Practice Address - Street 1:5224 3RD ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-1810
Practice Address - Country:US
Practice Address - Phone:844-782-8300
Practice Address - Fax:844-782-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30543601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30543601Medicaid