Provider Demographics
NPI:1134915861
Name:MASTERY HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:MASTERY HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANU
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTOSH NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-301-4753
Mailing Address - Street 1:331 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3364
Mailing Address - Country:US
Mailing Address - Phone:215-301-4753
Mailing Address - Fax:
Practice Address - Street 1:331 N 9TH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3364
Practice Address - Country:US
Practice Address - Phone:215-301-4753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health