Healthcare Provider Details

I. General information

NPI: 1427525708
Provider Name (Legal Business Name): DELIA MARIA HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945-47 N. 5TH STREET
PHILADELPHIA PA
19133
US

IV. Provider business mailing address

2945-47 N. 5TH STREET
PHILADELPHIA PA
19133
US

V. Phone/Fax

Practice location:
  • Phone: 215-288-3653
  • Fax: 215-790-6257
Mailing address:
  • Phone: 215-288-3653
  • Fax: 215-790-6257

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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. EVELYN DEL VALLE
Title or Position: OWNER/CEO
Credential:
Phone: 215-288-3653