Organization
LOOKING OUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ONJA MAYNARD (CEO)
(570) 328-3265
Entity
Organization
Contact information
Practice address
12031 NASHVILLE BLVD, SAINT ALBANS, NY 11412-3829
(570) 328-3265
Mailing address
12031 NASHVILLE BLVD, SAINT ALBANS, NY 11412-3829
(570) 328-3265
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
Other
Enumeration date
04/23/2021
Last updated
09/07/2021
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