Provider Demographics
NPI:1457033516
Name:ADORATION HOME HEALTH CARE PENNSYLVANIA, LLC
Entity Type:Organization
Organization Name:ADORATION HOME HEALTH CARE PENNSYLVANIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-896-5782
Mailing Address - Street 1:20 ERFORD RD STE 212
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1400
Mailing Address - Country:US
Mailing Address - Phone:717-869-5655
Mailing Address - Fax:
Practice Address - Street 1:20 ERFORD RD STE 212
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1400
Practice Address - Country:US
Practice Address - Phone:717-869-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health