1023352499 NPI number — HEART 4 HELPING SENIORS, LLC

Table of content: MS. ALBERTINA I. WASHINGTON-GREEN MA, LPC (NPI 1568416238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023352499 NPI number — HEART 4 HELPING SENIORS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART 4 HELPING SENIORS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SENIORS HELPING SENIORS OF MONTCO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023352499
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
307 DEERHAVEN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENMOORE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19343-8922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-334-4276
Provider Business Mailing Address Fax Number:
866-929-6872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
307 DEERHAVEN WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENMOORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19343-8922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-334-4276
Provider Business Practice Location Address Fax Number:
866-929-6872
Provider Enumeration Date:
11/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TROUT
Authorized Official First Name:
DARA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-334-4276

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  15523601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X , with the licence number: 15523601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1028849000001 . This is a "PROMISE (MEDICAID WAIVER)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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