Healthcare Provider Details

I. General information

NPI: 1689673782
Provider Name (Legal Business Name): KEY CARE HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 LINCOLN HWY E
JEANNETTE PA
15644-3141
US

IV. Provider business mailing address

70 LINCOLN HWY E
JEANNETTE PA
15644-3141
US

V. Phone/Fax

Practice location:
  • Phone: 724-527-0280
  • Fax: 724-527-5922
Mailing address:
  • Phone: 724-527-0280
  • Fax: 724-527-5922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number720605
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier1007572830028
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier0718
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK
# 3
Identifier97784
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH AMERICA

VIII. Authorized Official

Name: DONNA KAMINSKY
Title or Position: INTERIM C E O
Credential:
Phone: 724-527-1511