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General NPI Number Information
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NPI Number | 1508187055
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Entity Type | Organization
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Legal Business Name | ANTHRACITE PERSONAL CARE AGENCY, INC.
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 545 N 3RD ST
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City | MINERSVILLE
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State | PA
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Zip | 17954-1309
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Country | US
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Telephone | 570-544-3780
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Fax | 570-544-3782
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Provider Business Mailing Address
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Address Line | 545 N 3RD ST
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City | MINERSVILLE
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State | PA
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Zip | 17954-1309
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Country | US
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Telephone | 570-544-3780
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Fax | 570-544-3782
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DEBORAH ANN HANEY
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Credential |
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Telephone | 570-544-3780
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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 | 14993601
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License Number State | PA
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