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Provider Demographic Information - PCG ODP EIM PROVIDER THREE

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	PCG ODP EIM PROVIDER THREE
Address:	754 ROSLY AVE PHILADELPHIA, PA 19107-3323
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:	PCG ODP EIM PROVIDER THREE
Address:	754 ROSLY AVE PHILADELPHIA, PA 19107-3323
Phone:	(717) 555-5555

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PROVIDER SERVICES AND RATES Supporting line for group header


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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Armstrong/Indiana
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Bedford/Somerset
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
FSS/Individual Payment-Dollar	Not Set
Supports Coordination	$11.00 - $35.00 / 15 min.
Visual/Mobility Therapy-15 min	Not Set
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Bradford/Sullivan
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Cameron/Elk
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Carbon/Monroe/Pike
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Clearfield/Jefferson
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Cumberland/Perry
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
FSS/Individual Payment-Dollar	Not Set
Needs Exception Allowance (NEA)-Child Res (3800)	Not Set
Supports Coordination	$11.00 - $35.00 / 15 min.
Visual/Mobility Therapy-15 min	Not Set
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Forest/Warren
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Franklin/Fulton
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Huntingdon/Mifflin/Juniata
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : Lackawanna/Susquehanna
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$11.00 - $15.00 / 15 min.
Life Sharing (Base Only)	Not Set
Needs Exception Allowance (NEA)-CRR Adult	Not Set
Respite Only Home-2 People-Lic-Day-NG 3	$11.00 - $25.00 / 1 Day
Supported Employment - Career Assessment-U4-ECS	Not Set
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $35.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

County : York/Adams
\|Service Name / Level	\|Rate

Behavioral Support - ECS	$11.00 - $25.00 / 15 min.
CPS 100% Cmnty with 1:1 (Level 3 Enhcd) LPN-ECS	$11.00 - $15.00 / 15 min.
CPS 100% Community with 2:1	$11.00 / 15 min.
Companion Services (Basic Staff Support)	$11.00 - $15.00 / 15 min.
Supports Coordination	$11.00 - $22.00 / 15 min.
WO3034-PH2-CLW Service	$11.00 - $35.00 / Unit

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