Organization
HAVENDALE LLC
Active
Other names
FirstLight HomeCare Southwest Pittsburgh
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MYKAL KOUSINS (OWNER/CEO)
(724) 914-9829
Entity
Organization
Contact information
Practice address
3244 WASHINGTON RD, SUITE 239, MC MURRAY, PA 15317-6403
(724) 914-8929
(724) 941-4299
Mailing address
3244 WASHINGTON RD, SUITE 239, MC MURRAY, PA 15317-6403
(724) 914-8929
(724) 941-4299
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
28273601
PA
253Z00000X
In Home Supportive Care Agency
Primary
28273601
PA
Other
Enumeration date
06/25/2015
Last updated
06/20/2016
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