Healthcare Provider Details

I. General information

NPI: 1417316928
Provider Name (Legal Business Name): ENSPIRIT ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 S 4TH ST SUITE 245
PHILADELPHIA PA
19147-1570
US

IV. Provider business mailing address

525 S 4TH ST SUITE 245
PHILADELPHIA PA
19147-1570
US

V. Phone/Fax

Practice location:
  • Phone: 267-499-4700
  • Fax: 267-480-2990
Mailing address:
  • Phone: 267-499-4700
  • Fax: 267-480-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number26273601
License Number StatePA

VIII. Authorized Official

Name: MS. LISA M DIMEO
Title or Position: OWNER
Credential:
Phone: 267-499-4700