Healthcare Provider Details

I. General information

NPI: 1780490078
Provider Name (Legal Business Name): PEACEFUL HEARTS STAFFING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N OLIVE ST
MEDIA PA
19063-2835
US

IV. Provider business mailing address

211 N OLIVE ST
MEDIA PA
19063-2835
US

V. Phone/Fax

Practice location:
  • Phone: 610-766-1496
  • Fax:
Mailing address:
  • Phone: 610-766-1496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MASERAY FOFANAH
Title or Position: PRESIDENT
Credential:
Phone: 610-766-1496