Provider Demographics
NPI:1427488667
Name:ADVOCATE HOME HEALTH CARE & PRIVATE DUTY
Entity type:Organization
Organization Name:ADVOCATE HOME HEALTH CARE & PRIVATE DUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:NEWCOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-322-4465
Mailing Address - Street 1:454 PINE STREET PO BOX 4062
Mailing Address - Street 2:GLR
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-0662
Mailing Address - Country:US
Mailing Address - Phone:570-322-4465
Mailing Address - Fax:570-323-2033
Practice Address - Street 1:454 PINE ST
Practice Address - Street 2:GLR
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6200
Practice Address - Country:US
Practice Address - Phone:570-322-4465
Practice Address - Fax:570-323-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA18853601311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home