Provider Demographics
NPI:1891100202
Name:HIDDEN DOVE HOMECARE
Entity Type:Organization
Organization Name:HIDDEN DOVE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-336-4676
Mailing Address - Street 1:8031 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-1724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:610-336-4677
Practice Address - Street 1:8031 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1724
Practice Address - Country:US
Practice Address - Phone:610-336-4676
Practice Address - Fax:610-336-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health