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General NPI Number Information
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NPI Number | 1043440258
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Entity Type | Organization
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Legal Business Name | COMMUNITY RESOURCES FOR INDEPENDENCE INC
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 3410 W 12TH ST
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City | ERIE
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State | PA
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Zip | 16505-3649
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Country | US
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Telephone | 814-838-7222
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 W 12TH ST
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City | ERIE
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State | PA
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Zip | 16505-3649
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Country | US
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Telephone | 814-838-7222
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. MARTIN M PUSHCHAK
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Credential |
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Telephone | 814-838-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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