Provider Demographics
NPI:1316943921
Name:COMMUNITY HOME HEALTH, INC
Entity type:Organization
Organization Name:COMMUNITY HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSARO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-396-8252
Mailing Address - Street 1:351 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7711
Mailing Address - Country:US
Mailing Address - Phone:215-396-8252
Mailing Address - Fax:215-396-8253
Practice Address - Street 1:351 E STREET RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7711
Practice Address - Country:US
Practice Address - Phone:215-396-8252
Practice Address - Fax:215-396-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39-7668251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015797910005Medicaid
PA0015797910006Medicaid
PA0015797910006Medicaid