Organization
TRADITIONAL HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN NIXON RN (REGISTERED NURSE)
(570) 507-9420
Entity
Organization
Contact information
Practice address
1439 MONROE AVE STE 6, DUNMORE, PA 18509-2497
(570) 507-9420
Mailing address
113 W DRINKER ST, DUNMORE, PA 18512-1913
(570) 207-9286
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
28573601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28573601
PA DEPARMTNET OF HEALTH
PA
Enumeration date
09/03/2015
Last updated
01/08/2020
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