Provider Demographics
NPI:1104281534
Name:PRIVATE HOME CARE, INC.
Entity type:Organization
Organization Name:PRIVATE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STROUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-2100
Mailing Address - Street 1:P.O. BOX 324
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915
Mailing Address - Country:US
Mailing Address - Phone:207-338-2100
Mailing Address - Fax:207-338-1234
Practice Address - Street 1:243 HIGH ST.
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-338-2100
Practice Address - Fax:207-338-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty