1851513709 NPI number — INDEPENDENT SENIOR LLC

Table of content: (NPI 1851513709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851513709 NPI number — INDEPENDENT SENIOR LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INDEPENDENT SENIOR 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:
HOME INSTEAD SENIOR CARE
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:
1851513709
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:
125 HARTMAN RD
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-6463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-836-5795
Provider Business Mailing Address Fax Number:
724-836-5799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4101 BROWNSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE LL100
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15227-3336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-884-6122
Provider Business Practice Location Address Fax Number:
412-884-6144
Provider Enumeration Date:
05/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZURAWSKY
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-836-5795

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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