Provider Demographics
NPI:1962959973
Name:AMERISTAR HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:AMERISTAR HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:CHANGWONY
Authorized Official - Last Name:CHEBARWETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:717-598-5288
Mailing Address - Street 1:457 AMESBURY RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3533
Mailing Address - Country:US
Mailing Address - Phone:717-598-5288
Mailing Address - Fax:
Practice Address - Street 1:457 AMESBURY RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3533
Practice Address - Country:US
Practice Address - Phone:717-598-5288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA06390501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health