Healthcare Provider Details

I. General information

NPI: 1790339505
Provider Name (Legal Business Name): SILVERBIRD HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8033 OLD YORK RD STE 214
ELKINS PARK PA
19027-1422
US

IV. Provider business mailing address

2802 RAWLE ST
PHILADELPHIA PA
19149-2521
US

V. Phone/Fax

Practice location:
  • Phone: 215-635-1078
  • Fax:
Mailing address:
  • Phone: 215-635-1078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: OLAITAN OLUKANNI
Title or Position: PRESIDENT
Credential:
Phone: 215-635-1078