Healthcare Provider Details

I. General information

NPI: 1003820689
Provider Name (Legal Business Name): HOMESTEAD UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 BLOOMFIELD ST STE 201
JOHNSTOWN PA
15904-3271
US

IV. Provider business mailing address

336 BLOOMFIELD ST STE 201
JOHNSTOWN PA
15904-3271
US

V. Phone/Fax

Practice location:
  • Phone: 814-471-2876
  • Fax: 814-262-7415
Mailing address:
  • Phone: 814-471-2877
  • Fax: 814-262-7415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHAD M UNVERFERTH
Title or Position: VICE PRESIDENT-FINANCE, TREASURER &
Credential:
Phone: 419-999-2010