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General NPI Number Information
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NPI Number | 1790395325
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Entity Type | Organization
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Legal Business Name | FOREVER YOURS HOME CARE STAFFING AGENCY LLC
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 1419 SCOTT ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-4432
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Country | US
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Telephone | 157-047-8433
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 SCOTT ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-4432
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Country | US
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Telephone | 570-433-1384
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. HARRY EUGENE JONES III
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Credential |
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Telephone | 570-433-1384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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