MEDICARE: ABODE CARE SERVICES, 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	251E00000X	Home Health Agency	31793601	PA

General Provider Information

NPI Number	:	1821509639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABODE CARE SERVICES, LLC.

Provider Business Mailing Address
First Line	:	1207 S WILTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1207 S WILTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4321
Country	:	US
Telephone Number	:	267-344-7831
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	ERICA CALEB
Credential	:
Telephone Number	:	267-344-7831

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	10/19/2017

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