=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720101314
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASTERN AREA ADULT SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2007
-----------------------------------------------------
Last Update Date | 12/29/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 WEST ST
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15221-2833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-247-1446
-----------------------------------------------------
Fax | 412-247-1973
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 607 BRADDOCK AVENUE
-----------------------------------------------------
City | TURTLE CREEK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15145-2069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-829-9250
-----------------------------------------------------
Fax | 412-829-9251
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | LINDA DOMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 412-829-9250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------