Healthcare Provider Details

I. General information

NPI: 1073161303
Provider Name (Legal Business Name): COMMUNITY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E PENNSYLVANIA AVE
NEW STANTON PA
15672-2700
US

IV. Provider business mailing address

201 E PENNSYLVANIA AVE
NEW STANTON PA
15672-2700
US

V. Phone/Fax

Practice location:
  • Phone: 724-830-9918
  • Fax: 724-830-9919
Mailing address:
  • Phone: 724-830-9918
  • Fax: 724-830-9919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WASIL W WALESKI
Title or Position: ADMINISTRATOR
Credential: MPAC
Phone: 724-830-9918