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General NPI Number Information
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NPI Number | 1962366245
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HEIGHTS OF NEW BERLIN
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 78 HOMESTEAD HEIGHTS DR.
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City | MIFFLINBURG
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State | PA
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Zip | 17844
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Country | US
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Telephone | 570-217-0066
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Fax | 570-209-8845
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | NEW BERLIN
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State | PA
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Zip | 17855-0144
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Country | US
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Telephone | 570-217-0066
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Fax | 570-209-8845
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DAVE WENGERD
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Credential | ALRA
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Telephone | 570-217-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number |
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License Number State |
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