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General NPI Number Information
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NPI Number | 1053304345
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Entity Type | Organization
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Legal Business Name | GOLDEN CARE OF NORTHEAST PA, INC.
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 200 OVERLOOK DR SUITE 235
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City | PITTSTON
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State | PA
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Zip | 18640-1016
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Country | US
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Telephone | 570-654-2883
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Fax | 570-883-9709
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Provider Business Mailing Address
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Address Line | 200 OVERLOOK DR SUITE 235
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City | PITTSTON
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State | PA
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Zip | 18640-1016
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Country | US
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Telephone | 570-654-2883
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Fax | 570-883-9709
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MICHELLE M. BERNARDI
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Credential | CRNP
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Telephone | 570-654-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 397286
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License Number State | PA
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