Healthcare Provider Details
I. General information
NPI: 1033116082
Provider Name (Legal Business Name): ARN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2005
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 E. BROAD ST. SUITE C
HAZLETON PA
18201-5695
US
IV. Provider business mailing address
1710 E. BROAD ST. SUITE C
HAZLETON PA
18201-5695
US
V. Phone/Fax
- Phone: 570-459-3004
- Fax: 570-459-3009
- Phone: 570-459-3004
- Fax: 570-459-3009
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 0016830830001 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
MARIO
IEZZONI
Title or Position: CFO VP
Credential: CPA
Phone: 570-459-3004