Healthcare Provider Details

I. General information

NPI: 1073277869
Provider Name (Legal Business Name): KARYCARE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 W CHESTER PIKE
HAVERTOWN PA
19083-5331
US

IV. Provider business mailing address

126 W CHESTER PIKE
HAVERTOWN PA
19083-5331
US

V. Phone/Fax

Practice location:
  • Phone: 215-944-4541
  • Fax:
Mailing address:
  • Phone: 215-944-4541
  • Fax: 215-944-4642

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: FERNAND OUATTARA
Title or Position: CEO
Credential:
Phone: 215-944-4541