Healthcare Provider Details

I. General information

NPI: 1083005706
Provider Name (Legal Business Name): ALLE-KISKI CAREGIVERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 THORN ST
APOLLO PA
15613-8412
US

IV. Provider business mailing address

1596 HANCOCK AVE
APOLLO PA
15613-8404
US

V. Phone/Fax

Practice location:
  • Phone: 724-568-4251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number26843601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MEGHAN RENEE KEY
Title or Position: ADMINISTRATOR/MANAGING MEMBER
Credential: M.P.H.
Phone: 724-568-4251