Healthcare Provider Details

I. General information

NPI: 1447012463
Provider Name (Legal Business Name): YOUR OWN HOME,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BRANDYWINE BLVD # A
TALLEYVILLE DE
19803-1838
US

IV. Provider business mailing address

17 BRANDYWINE BLVD # A
TALLEYVILLE DE
19803-1838
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-7081
  • Fax:
Mailing address:
  • Phone: 302-478-7081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GINA DENEY
Title or Position: OWNER
Credential:
Phone: 302-478-7081