Healthcare Provider Details

I. General information

NPI: 1356950406
Provider Name (Legal Business Name): WILLOW TREE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 PHOENIX AVE
BELLEFONTE PA
16823-1309
US

IV. Provider business mailing address

374 PHOENIX AVE
BELLEFONTE PA
16823-1309
US

V. Phone/Fax

Practice location:
  • Phone: 814-810-2389
  • Fax: 814-810-2390
Mailing address:
  • Phone: 814-810-2389
  • Fax: 814-810-2390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARLEEN MATSKO
Title or Position: ADMINISTRATOR
Credential: RN-BC, BSN
Phone: 814-810-2389