=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407857493
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREGIVERS PLUS HOME HEALTH CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/02/2005
-----------------------------------------------------
Last Update Date | 04/05/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 56 DUTCH LN
-----------------------------------------------------
City | HERMITAGE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16148-3305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-347-2124
-----------------------------------------------------
Fax | 724-347-0506
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 56 DUTCH LN
-----------------------------------------------------
City | HERMITAGE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16148-2744
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-347-2124
-----------------------------------------------------
Fax | 724-347-0506
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | ROBERT ALLAN DEVINE
-----------------------------------------------------
Credential | BS,RN
-----------------------------------------------------
Telephone | 724-347-2124
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 765405
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------