Healthcare Provider Details

I. General information

NPI: 1689710154
Provider Name (Legal Business Name): ENCOMPASS HEALTH HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 MAIN ST
BINGHAMTON NY
13905-2610
US

IV. Provider business mailing address

232 MAIN STREET
BINGHAMTON NY
13905
US

V. Phone/Fax

Practice location:
  • Phone: 607-729-9166
  • Fax:
Mailing address:
  • Phone: 607-729-9166
  • Fax: 607-729-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY DIEGERT
Title or Position: CFO
Credential:
Phone: 607-729-9166