Healthcare Provider Details

I. General information

NPI: 1871579383
Provider Name (Legal Business Name): FAYETTE HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 YOUNGSTOWN RD
LEMONT FURNACE PA
15456-1020
US

IV. Provider business mailing address

110 YOUNGSTOWN RD
LEMONT FURNACE PA
15456-1020
US

V. Phone/Fax

Practice location:
  • Phone: 724-439-1610
  • Fax: 724-430-6892
Mailing address:
  • Phone: 724-439-1610
  • Fax: 724-430-6892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number397134
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number391556
License Number StatePA

VIII. Authorized Official

Name: MRS. VICKIE HARDY LEONE
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 724-439-1610