MEDICARE: HOME NURSING AGENCY COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator
3	222Q00000X	Developmental Therapist
4	225100000X	Physical Therapist
5	225CX0006X	Orientation and Mobility Training Rehabilitation Counselor
6	225X00000X	Occupational Therapist
7	235Z00000X	Speech-Language Pathologist
8	252Y00000X	Early Intervention Provider Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285792861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME NURSING AGENCY COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	201 CHESTNUT AVE
Second Line	:	EARLY INTERVENTION
City	:	ALTOONA
State	:	PA
Zip	:	16601-4927
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:	814-941-1648

Provider Business Practice Location Address
First Line	:	400 LAKEMONT PARK BLVD
Second Line	:	SUITE 100 EARLY INTERVENTION
City	:	ALTOONA
State	:	PA
Zip	:	16602-5967
Country	:	US
Telephone Number	:	814-946-0261
Fax Number	:	814-943-6198

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PHILIP L FREEMAN JR.
Credential	:
Telephone Number	:	814-946-5411

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	05/07/2015

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