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General NPI Number Information
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NPI Number | 1396890109
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Entity Type | Organization
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Legal Business Name | PAXTON STREET HOME BENEVOLENT SOCIETY INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2001 PAXTON ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1040
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Country | US
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Telephone | 717-236-5508
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Fax | 717-236-3099
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Provider Business Mailing Address
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Address Line | 2001 PAXTON ST
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City | HARRISBURG
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State | PA
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Zip | 17111-1040
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Country | US
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Telephone | 717-236-5508
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Fax | 717-236-3099
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS SERVICES
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Name | MR. KEVIN NOLL
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Credential |
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Telephone | 717-236-5508
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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 | 342010
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License Number State | PA
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