Healthcare Provider Details

I. General information

NPI: 1306631890
Provider Name (Legal Business Name): ENGAGE AS YOU AGE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N ELM AVE
ALDAN PA
19018-4103
US

IV. Provider business mailing address

509 FAIRNEST CT
DOVER DE
19904-9786
US

V. Phone/Fax

Practice location:
  • Phone: 267-506-0184
  • Fax:
Mailing address:
  • Phone: 267-506-0184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MISS KENISHA NEMBHARD
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 267-506-0184