Healthcare Provider Details

I. General information

NPI: 1942255237
Provider Name (Legal Business Name): HOME HEALTH SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5039 TOWNSHIP LINE RD FL 2
DREXEL HILL PA
19026-4847
US

IV. Provider business mailing address

2203 N LOIS AVE STE 700
TAMPA FL
33607-2387
US

V. Phone/Fax

Practice location:
  • Phone: 610-566-2700
  • Fax: 610-892-9032
Mailing address:
  • Phone: 813-850-0042
  • Fax: 813-850-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number728205
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0009941040003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier0009941040005
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 3
Identifier0009941040007
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: EMMA DE JESUS
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 813-850-0042