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General NPI Number Information
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NPI Number | 1487748307
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Entity Type | Organization
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Legal Business Name | FAYETTE HOMECARE
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 110 YOUNGSTOWN ROAD
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City | LEMONT FURNACE
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State | PA
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Zip | 15456
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Country | US
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Telephone | 724-430-6828
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Fax | 724-430-6892
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Provider Business Mailing Address
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Address Line | 110 YOUNGSTOWN ROAD
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City | LEMONT FURNACE
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State | PA
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Zip | 15456
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Country | US
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Telephone | 724-430-6828
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Fax | 724-430-6892
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. VICKIE LEONE
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Credential |
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Telephone | 724-430-6828
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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 | 713405
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 155699
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License Number State | PA
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