Healthcare Provider Details

I. General information

NPI: 1831051887
Provider Name (Legal Business Name): HEALEDATHOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2025
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 WALSH RD
LANSDOWNE PA
19050-2116
US

IV. Provider business mailing address

119 WALSH RD
LANSDOWNE PA
19050-2116
US

V. Phone/Fax

Practice location:
  • Phone: 610-638-5359
  • Fax:
Mailing address:
  • Phone: 610-638-5359
  • 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
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MALIKH BUTLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 610-638-5359