MEDICARE: CHILDREN'S AID HOME PROGRAMS OF SOMERSET COUNTY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1336832377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S AID HOME PROGRAMS OF SOMERSET COUNTY INC

Provider Business Mailing Address
First Line	:	PO BOX 1195
Second Line	:
City	:	SOMERSET
State	:	PA
Zip	:	15501-0320
Country	:	US
Telephone Number	:	814-443-1637
Fax Number	:	814-445-8481

Provider Business Practice Location Address
First Line	:	1476 N CENTER AVE
Second Line	:
City	:	SOMERSET
State	:	PA
Zip	:	15501-1632
Country	:	US
Telephone Number	:	814-443-1637
Fax Number	:	814-445-8481

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	CARLA WESS
Credential	:
Telephone Number	:	814-443-1637

Provider Enumeration Date	:	05/26/2023
Last Update Date	:	05/26/2023

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