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General NPI Number Information
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NPI Number | 1518901610
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN HEALTH SERVICES OF PENNSYLVANIA, LLC
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 1501 GRUNDY LN SUITE 100
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City | BRISTOL
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State | PA
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Zip | 19007-1506
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Country | US
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Telephone | 215-826-0900
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Fax | 215-826-8300
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Provider Business Mailing Address
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Address Line | 1501 GRUNDY LN SUITE 100
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City | BRISTOL
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State | PA
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Zip | 19007-1506
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Country | US
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Telephone | 215-826-0900
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Fax | 215-826-8300
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MR. HEATHER SISCEL
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Credential |
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Telephone | 215-826-0900
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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 | 747205
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License Number State | PA
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