Healthcare Provider Details

I. General information

NPI: 1811581952
Provider Name (Legal Business Name): PAHM-NY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 03/01/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 OREGON PIKE
LANCASTER PA
17601-4604
US

IV. Provider business mailing address

2141 OREGON PIKE
LANCASTER PA
17601-4604
US

V. Phone/Fax

Practice location:
  • Phone: 717-808-6179
  • Fax: 717-517-9501
Mailing address:
  • Phone: 717-808-6179
  • Fax: 717-517-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE GILL
Title or Position: EXECUTIVE DIRECTOR
Credential: BA
Phone: 717-808-6179