Healthcare Provider Details

I. General information

NPI: 1528055712
Provider Name (Legal Business Name): JEFFCO HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 ROUTE 28
BROOKVILLE PA
15825-7181
US

IV. Provider business mailing address

417 ROUTE 28
BROOKVILLE PA
15825-7181
US

V. Phone/Fax

Practice location:
  • Phone: 814-849-8026
  • Fax: 814-849-8026
Mailing address:
  • Phone: 814-849-8026
  • Fax: 814-849-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100802
License Number StatePA

VIII. Authorized Official

Name: MISTY S FLEMING
Title or Position: ADMINISTRATOR
Credential:
Phone: 814-849-8026