Organization
CHURCH ROAD HOME LLC
Active
Other names
Church Road Home LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D GAINER (EXECUTIVE DIRECTOR)
(717) 712-4578
Entity
Organization
Contact information
Practice address
1669 CHURCH RD, HERSHEY, PA 17033-1812
(717) 525-2156
Mailing address
201 TRAIL RD, HERSHEY, PA 17033-9425
(717) 712-4578
(717) 312-8903
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6701495233
—
PA
Enumeration date
07/28/2020
Last updated
07/28/2020
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