Healthcare Provider Details

I. General information

NPI: 1205788783
Provider Name (Legal Business Name): HAPPY GRANPS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W COULTER ST
PHILADELPHIA PA
19144-4550
US

IV. Provider business mailing address

405 W COULTER ST
PHILADELPHIA PA
19144-4550
US

V. Phone/Fax

Practice location:
  • Phone: 215-403-1790
  • Fax:
Mailing address:
  • Phone: 215-403-1790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name: GEORGETTA DEVON WELLMAN
Title or Position: CO-OWNER/CEO
Credential:
Phone: 267-235-7071