Provider Demographics
NPI:1396797163
Name:RESIDENTIAL HOME HEALTH OF CARLISLE, LLC
Entity type:Organization
Organization Name:RESIDENTIAL HOME HEALTH OF CARLISLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-524-6401
Mailing Address - Street 1:5440 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 STERLING PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2903
Practice Address - Country:US
Practice Address - Phone:888-923-5842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA397047251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2597125OtherAETNA
PA1844OtherHIGHMARK
PA1520901OtherGATEWAY
PA397047OtherCAPITAL BLUE CROSS
PA397047Medicare Oscar/Certification
PA397047OtherCAPITAL BLUE CROSS