Church Road Home LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

CHURCH ROAD HOME LLC

Doing business as

Church Road Home LLC

Practice address

1669 Church Rd
Hershey, PA 17033-1812

Phone

(717) 525-2156

NPI assigned

Jul 28, 2020

Last updated

Jul 28, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James D Gainer

Title

Executive Director

Phone

(717) 712-4578

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Church Road Home LLC Doing business as

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1407465214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 TRAIL RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170339425",
            "telephone_number": "717-712-4578",
            "fax_number": "717-312-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 CHURCH RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170331812",
            "telephone_number": "717-525-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH ROAD HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "GAINER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "717-712-4578"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701495233",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgainer@hopespringsfarm.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1669 Church Rd",
            "city": "Hershey",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170331812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Church Road Home LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David C Chu, M.D.
• Katherine Chu
• Cynthia H Chuang, MD
• Ching Chung
• James Chung
• Robert Ryan Ciancaglini Jr.
• Ian Paul Ciesielski, MD, MS
• Michael Cimmino, DO
• Madison Cinnamo, AUD
• Jennifer Mandy Cinqmars, RN

• Home Health Aide in Hershey, PA
• Providers in Hershey, PA by specialty
• Home Health Aide in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.