Healthcare Provider Details

I. General information

NPI: 1619459583
Provider Name (Legal Business Name): ABLE HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SCHOOL SIDE DR
THROOP PA
18512-1456
US

IV. Provider business mailing address

301 SCHOOL SIDE DR
THROOP PA
18512-1456
US

V. Phone/Fax

Practice location:
  • Phone: 570-499-0228
  • Fax: 570-343-4849
Mailing address:
  • Phone: 570-499-0228
  • Fax: 570-343-4849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GARY MCDONOUGH
Title or Position: OWNER / PRESIDENT
Credential:
Phone: 570-499-0228