Organization
CENTERWELL CERTIFIED HEALTHCARE CORP.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(570) 424-7790
Entity
Organization
Contact information
Practice address
1250 N 9TH ST, SUITE 105, STROUDSBURG, PA 18360-7800
(570) 424-7790
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000076734
—
PA
01
—
009556
G2
—
01
—
013100P
G2
—
05
—
1006932660090
—
PA
01
—
1018806
G2
—
01
—
112802024
G2
—
01
—
113414024H
G2
—
05
—
1496438
—
PA
01
—
1500992
G2
—
01
—
2207607
G2
—
01
—
235392
G2
—
01
—
30941
G2
—
01
—
337224
G2
—
01
—
34253
G2
—
01
—
397422
G2
—
05
—
60621
—
PA
01
—
702022
G2
—
Enumeration date
07/11/2006
Last updated
12/15/2023
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