Provider Demographics
NPI:1265923130
Name:GODS CHILDREN MINISTRY HHA LLC
Entity type:Organization
Organization Name:GODS CHILDREN MINISTRY HHA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-608-4945
Mailing Address - Street 1:3218 WAKEFIELD RD APT C
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-6119
Mailing Address - Country:US
Mailing Address - Phone:717-963-4447
Mailing Address - Fax:717-233-1150
Practice Address - Street 1:202 STATE ST STE 2
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-1103
Practice Address - Country:US
Practice Address - Phone:717-610-3970
Practice Address - Fax:717-233-1150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GODS CHILDREN MINISTRY HHA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
82359880OtherHOME HEALTH
PA8235980OtherHOME HEALTH AGENCY