Healthcare Provider Details

I. General information

NPI: 1265491567
Provider Name (Legal Business Name): COMMUNITY NURSES HOME HEALTH AND HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 JOHNSONBURG ROAD SUITE 200
ST MARYS PA
15857-3497
US

IV. Provider business mailing address

757 JOHNSONBURG ROAD SUITE 200
ST MARYS PA
15857-3497
US

V. Phone/Fax

Practice location:
  • Phone: 814-781-1415
  • Fax: 814-781-6987
Mailing address:
  • Phone: 814-781-1415
  • Fax: 814-781-6987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number156299
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1005
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS HOSPICE
# 2
Identifier1000066150008
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: MRS. JENNIFER ANN CATALANO
Title or Position: CFO
Credential:
Phone: 814-781-4720