Healthcare Provider Details

I. General information

NPI: 1467741900
Provider Name (Legal Business Name): KINDRED HEARTS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 S 15TH ST APT #1-A
PHILADELPHIA PA
19146-2238
US

IV. Provider business mailing address

759 S 15TH ST APT #1-A
PHILADELPHIA PA
19146-2238
US

V. Phone/Fax

Practice location:
  • Phone: 215-847-9120
  • Fax:
Mailing address:
  • Phone: 215-847-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4009113
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number4009113
License Number StatePA

VIII. Authorized Official

Name: MS. MIKALL POWELL
Title or Position: PARTNER/CO-CEO
Credential: MSW
Phone: 215-847-9120