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General NPI Number Information
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NPI Number | 1871793125
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Entity Type | Organization
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Legal Business Name | STUEBGEN LLC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 230 MAIN STREET
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City | SAXONBURG
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State | PA
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Zip | 16056
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Country | US
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Telephone | 724-360-0099
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Fax | 724-360-0098
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Provider Business Mailing Address
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Address Line | PO BOX 277
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City | SAXONBURG
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State | PA
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Zip | 16056-0277
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Country | US
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Telephone | 724-360-0099
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Fax | 724-360-0098
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | LISSA DUMAGAN
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Credential | BA
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Telephone | 724-360-0099
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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 |
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License Number State | PA
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