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General NPI Number Information
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NPI Number | 1053511931
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Entity Type | Organization
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Legal Business Name | DIAKON LUTHERAN SOCIAL MINISTRIES
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 416 MAIN ST STE D
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City | HONESDALE
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State | PA
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Zip | 18431-1839
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Country | US
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Telephone | 570-251-8712
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Fax | 570-251-8716
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Provider Business Mailing Address
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Address Line | 416 MAIN ST STE D
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City | HONESDALE
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State | PA
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Zip | 18431-1839
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Country | US
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Telephone | 570-251-8712
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Fax | 570-251-8716
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | MR. CHUCK K WEIBLE
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Credential |
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Telephone | 717-795-0388
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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 | 02340501
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License Number State | PA
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