Provider Demographics
NPI:1447928478
Name:FOUNTAIN OF HOPE HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:FOUNTAIN OF HOPE HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KESCHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-733-5011
Mailing Address - Street 1:8715 PATHFINDER RD
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1298
Mailing Address - Country:US
Mailing Address - Phone:484-215-4821
Mailing Address - Fax:
Practice Address - Street 1:8715 PATHFINDER RD
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031-1298
Practice Address - Country:US
Practice Address - Phone:484-215-4821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care