Healthcare Provider Details

I. General information

NPI: 1306597406
Provider Name (Legal Business Name): FOREVER LOVE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 BRILL ST
PHILADELPHIA PA
19124-1249
US

IV. Provider business mailing address

1649 BRILL ST
PHILADELPHIA PA
19124-1249
US

V. Phone/Fax

Practice location:
  • Phone: 215-668-4753
  • Fax:
Mailing address:
  • Phone: 267-228-4950
  • 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

VIII. Authorized Official

Name: MICHELLE BURTON
Title or Position: PRESIDENT
Credential:
Phone: 267-228-4950