Healthcare Provider Details

I. General information

NPI: 1699873158
Provider Name (Legal Business Name): WRC HEALTH CARE SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 WESTERN AVE
BROOKVILLE PA
15825-1540
US

IV. Provider business mailing address

985 ROUTE 28
BROOKVILLE PA
15825-7213
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-5913
  • Fax: 814-849-2902
Mailing address:
  • Phone: 814-849-1205
  • Fax: 814-849-7426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number02240501
License Number StatePA

VIII. Authorized Official

Name: JULIE SWONGER
Title or Position: ADMINISTRATOR
Credential:
Phone: 814-849-5913