Organization
REVOLUTIONARY HOME HEALTH INC
Active
Parent organization
REVOLUTIONARY HOME HEALTH INC
Other names
Revolutionary Hospice
Organization subpart
Yes
Provider details
NPI number
Legal business name
REVOLUTIONARY HOME HEALTH INC
Authorized official
DR. KATHLEEN EVANINA CRNP (ADMINISTRATOR)
(570) 383-7502
Entity
Organization
Contact information
Practice address
829 SCRANTON CARBONDALE HWY, EYNON, PA 18403-1020
(570) 383-7502
(866) 600-7413
Mailing address
829 SCRANTON CARBONDALE HWY, EYNON, PA 18403-1020
(570) 383-7502
(866) 600-7413
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
17641601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014816520001
—
PA
Enumeration date
04/17/2015
Last updated
07/21/2020
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