MEDICARE: ADVANCED SUPPORT HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1265380224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SUPPORT HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	3200 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5612
Country	:	US
Telephone Number	:	215-419-5934
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARIA RIOS
Credential	:
Telephone Number	:	267-423-1826

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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