Provider Demographics
NPI:1528055712
Name:JEFFCO HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:JEFFCO HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-849-8026
Mailing Address - Street 1:417 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-7181
Mailing Address - Country:US
Mailing Address - Phone:814-849-8026
Mailing Address - Fax:814-849-3889
Practice Address - Street 1:417 ROUTE 28
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-7181
Practice Address - Country:US
Practice Address - Phone:814-849-8026
Practice Address - Fax:814-849-8026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENN HIGHLANDS HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-03
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001033463-0003Medicaid
PA395626OtherPTAN