Provider Demographics
NPI:1851762181
Name:JOANNE STITELER SENIOR CARE, LLC
Entity Type:Organization
Organization Name:JOANNE STITELER SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STITELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-477-5425
Mailing Address - Street 1:931 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3721
Mailing Address - Country:US
Mailing Address - Phone:484-477-5425
Mailing Address - Fax:
Practice Address - Street 1:931 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3721
Practice Address - Country:US
Practice Address - Phone:484-477-5425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW018705251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health