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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header
 
Name: GENE COOK SUPPORTS LLC
Address: 194 RACE TRACK RD
RUFFS DALE, PA 15679-1511
Phone: (724) 217-5479
E-mail: GENE@GENECOOKSUPPORTS.ORG
Web Site: N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header
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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header
 
Type: Corporate Office
Name: Gene Cook Supports LLC
Address: 194 RACE TRACK RD
RUFFS DALE, PA 15679-1511
Phone: (724) 217-5479
Fax: (724) 542-4643
 

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PROVIDER SERVICES AND RATES Supporting line for group header
 
County : Allegheny
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Companion Services (Basic Staff Support) $3.19 / 15 min.
Companion Services (Level 1) $4.42 / 15 min.
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) $2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) $12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home $2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home $7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced) $20.13 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home $15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home $90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home $119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home $176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home $491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home $317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home $805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home $630.98 / 1 Day
 
County : Beaver
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Companion Services (Basic Staff Support) $3.19 / 15 min.
Companion Services (Level 1) $4.42 / 15 min.
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) $12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD $12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE $12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home $2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home $7.95 / 15 min.
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD $491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE $491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home $317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home $805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home $630.98 / 1 Day
 
County : Bedford/Somerset
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS Not Set
 
County : Cambria
|Service Name / Level |Rate
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
 
County : Clarion
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
 
County : Erie
|Service Name / Level |Rate
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
 
County : Fayette
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Companion Services (Basic Staff Support) $3.19 / 15 min.
Companion Services (Level 1) $4.42 / 15 min.
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) $2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) $12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home $2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home $7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced) $20.13 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home $15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home $90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home $119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home $176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home $491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home $317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home $805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home $630.98 / 1 Day
 
County : Mercer
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
 
County : Montgomery
|Service Name / Level |Rate
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
 
County : Washington
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Companion Services (Basic Staff Support) $3.19 / 15 min.
Companion Services (Level 1) $4.42 / 15 min.
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) $2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) $12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TD $12.30 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) - TE $12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home $2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home $7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced) $20.13 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home $15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home $90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home $119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home $176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home $317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home $805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home $630.98 / 1 Day
 
County : Westmoreland
|Service Name / Level |Rate
Behavioral Supports-Level 1-Initial/Ongoing $22.08 / 15 min.
Companion Services (Basic Staff Support) $3.19 / 15 min.
Companion Services (Level 1) $4.42 / 15 min.
Companion Services (Level 2) $7.71 / 15 min.
In-Home & Commnty Supprts (Basic) $4.09 / 15 min.
In-Home & Commnty Supprts (Lvl 1) $5.76 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) LPN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh) RN $14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2) $10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) LPN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh) RN $23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3) $19.83 / 15 min.
Respite-Unlic- 15-min (Basic 1:4) $2.26 / 15 min.
Respite-Unlic- 15-min(Level 3, 1:1 Enhcd) $12.30 / 15 min.
Respite-Unlic-15-min(Level 1, 1:3) In-Home $2.98 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)In-Home $7.95 / 15 min.
Respite-Unlic-15-min(Level 4, 2:1 Enhanced) $20.13 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home $15.77 / 15 min.
Respite-Unlic-Day (Basic 1:4) In-Home $90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home $119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home $176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home $491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home $317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home $805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home $630.98 / 1 Day
 
County : York/Adams
|Service Name / Level |Rate
Respite-Unlic-15-min(Level 2, 1:2)In-Home $4.40 / 15 min.

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