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Provider Demographic Information - SUNCOM INDUSTRIES INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	SUNCOM INDUSTRIES INC
Address:	PO BOX 46 NORTHUMBERLAND, PA 17857-0046
Phone:	(570) 473-8352
Fax:	(570) 473-0159
E-mail:	PVITALE@SUNCOM.ORG
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	SUNCOM INDUSTRIES, INC.
Address:	PO BOX 46 NORTHUMBERLAND, PA 17857-0046
Phone:	(570) 473-8352
Fax:	(570) 473-0159


Type:	Regional/Field Office	Counties Served:	Northumberland
Name:	SUNCOM INDUSTRIES INC
Address:	1201 W ARCH ST COAL TOWNSHIP, PA 17866-1807
Phone:	(570) 648-5027

Type:	Regional/Field Office			Counties Served:	Montour, Northumberland, Snyder, Union
Name:	SUNCOM INDUSTRIES
Address:	404 SUSQUEHANNA TRL NORTHUMBERLAND, PA 17857-8511
Phone:	(570) 473-1770
Fax:	(570) 473-5404


Type:	Regional/Field Office	Counties Served:	Columbia, Montour, Northumberland, Snyder, Union
Name:	SUNCOM INDUSTRIES, INC
Address:	128 WATER ST NORTHUMBERLAND, PA 17857-1941
Phone:	(570) 473-8352
Fax:	(570) 473-0159


Type:	Regional/Field Office	Counties Served:	Columbia, Luzerne, Montour, Northumberland
Name:	SUNCOM INDUSTRIES, INC.
Address:	164 W 9TH ST BLOOMSBURG, PA 17815-2613
Phone:	(570) 387-0830
Fax:	(570) 387-1860

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Columbia/Montour/Snyder/Union
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$21.42 / 15 min.
Small Group Employment (Base)-15 min	$2.48 / 15 min.
Small Group Employment (Level 2)-15 min	$7.52 / 15 min.
Small Group Employment (Level 3)-15 Mins	$14.20 / 15 min.
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Luzerne/Wyoming
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.10 / 15 min.
Small Group Employment (Base)-15 min	$2.48 / 15 min.
Small Group Employment (Level 2)-15 min	$7.52 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Lycoming/Clinton
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.

County : Northumberland
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Small Group Employment (Level 2)-15 min	$7.52 / 15 min.
Supported Employment-Career Assessment	$19.34 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$19.34 / 15 min.
Supported Emplymnt-Job Support - 1:1	$19.34 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Schuylkill
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:1	$26.59 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Transportation(Zone 1)-Trip	$36.54 / Trip
Transportation(Zone 2)-Trip	$65.78 / Trip
Transportation(Zone 3)-Trip	$74.73 / Trip

County : Wayne
\|Service Name / Level	\|Rate

CPS Community 1:1	$13.83 / 15 min.
CPS Community 1:2 or 1:3	$7.54 / 15 min.
CPS Community 2:3	$11.26 / 15 min.
CPS Facility 1:1	$13.39 / 15 min.
CPS Facility 1:1 Enhanced	$18.65 / 15 min.
CPS Facility 1:1 Enhcd LPN	$18.65 / 15 min.
CPS Facility 1:1 Enhcd RN	$18.65 / 15 min.
CPS Facility 1:11 to 1:15	$3.20 / 15 min.
CPS Facility 1:2 to 1:3	$7.39 / 15 min.
CPS Facility 1:4 to 1:6	$5.65 / 15 min.
CPS Facility 1:7 to 1:10	$3.43 / 15 min.
CPS Facility 2:1	$25.67 / 15 min.
CPS Facility 2:1 Enhcd	$30.94 / 15 min.
CPS Facility 2:1 Enhcd LPN	$30.94 / 15 min.
CPS Facility 2:1 Enhcd RN	$30.94 / 15 min.
CPS:Community OnCall/Remote Support	$1.77 / 15 min.
Small Group Employment (Base)-15 min	$2.48 / 15 min.

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