Provider Demographics
NPI:1962118117
Name:YAHCARE LLC
Entity type:Organization
Organization Name:YAHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:717-282-8686
Mailing Address - Street 1:1821 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1248
Mailing Address - Country:US
Mailing Address - Phone:717-743-9051
Mailing Address - Fax:
Practice Address - Street 1:908 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2051
Practice Address - Country:US
Practice Address - Phone:717-282-8686
Practice Address - Fax:717-928-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104095892-0001Medicaid
PA65553601OtherDEPARTMENT OF HEALTH