Healthcare Provider Details

I. General information

NPI: 1780687913
Provider Name (Legal Business Name): COMMUNITY NURSING SERVICES OF NORTH EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PARK ST
NORTH EAST PA
16428-1016
US

IV. Provider business mailing address

7 PARK ST.
NORTH EAST PA
16428
US

V. Phone/Fax

Practice location:
  • Phone: 814-725-4300
  • Fax: 814-725-4664
Mailing address:
  • Phone: 814-725-4300
  • Fax: 814-725-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number708905
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number16451601
License Number StatePA

VIII. Authorized Official

Name: MS. TAMMY RENEE KECER-BROWN
Title or Position: EXECUTIVE DIRECTOR
Credential: MHA
Phone: 814-725-4300