Provider Demographics
NPI:1841275146
Name:COMMUNITY NURSES HOME HEALTH AND HOSPICE INC
Entity type:Organization
Organization Name:COMMUNITY NURSES HOME HEALTH AND HOSPICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SERVICE LINE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:814-781-1415
Mailing Address - Street 1:757 JOHNSONBURG RD., SUITE 200
Mailing Address - Street 2:
Mailing Address - City:ST. MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-3497
Mailing Address - Country:US
Mailing Address - Phone:814-781-1415
Mailing Address - Fax:814-781-6987
Practice Address - Street 1:504 PARK AVE
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-2116
Practice Address - Country:US
Practice Address - Phone:800-841-9397
Practice Address - Fax:800-843-9620
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-08
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
PA154299251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000066150017Medicaid
PA391542Medicare UPIN
391542Medicare ID - Type Unspecified