Healthcare Provider Details

I. General information

NPI: 1679349583
Provider Name (Legal Business Name): UNITED FAMILY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 07/08/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 BORBECK AVE
PHILADELPHIA PA
19111-2604
US

IV. Provider business mailing address

1031 BORBECK AVE
PHILADELPHIA PA
19111-2604
US

V. Phone/Fax

Practice location:
  • Phone: 267-499-7116
  • Fax:
Mailing address:
  • Phone: 267-499-7116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FAREEDA MOHAMMED
Title or Position: PRESIDENT
Credential: RN
Phone: 267-499-7116