1508078247 NPI number — TRY-AGAIN HOMES, INC.

Table of content: (NPI 1508078247)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508078247 NPI number — TRY-AGAIN HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRY-AGAIN HOMES, INC.
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:
Provider Other Organization Name Type Code:
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:
1508078247
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1228
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15301-7228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-225-0510
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
365 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-0510
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HILLIARD
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
724-225-0510

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  07CPP007 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 07CPP007 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 400950 . This is a "RESIDENTIAL SERVICES" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 424220 . This is a "FOSTER FAMILY CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 425130 . This is a "FOSTER FAMILY CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 412630 . This is a "PRIVATE CHILDREN & YOUTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 424210 . This is a "PRIVATE CHILDREN & YOUTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 409160 . This is a "ADOPTION SERVICES" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 424230 . This is a "ADOPTION SERVICES" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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