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Organization
LANDIS HCBS
Active
Organization
LANDIS HCBS
Active
Parent organization
LANDIS HCBS, LLC
Other names
Landis at Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
LANDIS HCBS, LLC
Authorized official
EVON L BERGEY LCSW (EXECUTIVE DIRECTOR)
(717) 874-8260
Entity
Organization
Contact information
Practice address
1001 E OREGON RD, LITITZ, PA 17543-9205
(717) 874-8260
Mailing address
1001 EAST OREGON RD., LITITZ, PA 17543
(717) 874-8260
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
13493601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13493601
PA DOH LICENSE
PA
Enumeration date
08/14/2018
Last updated
04/22/2019
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