Healthcare Provider Details

I. General information

NPI: 1487287074
Provider Name (Legal Business Name): AT HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8119 FRANKFORD AVE
PHILADELPHIA PA
19136-2757
US

IV. Provider business mailing address

9807 MONTOUR ST
PHILADELPHIA PA
19115-2208
US

V. Phone/Fax

Practice location:
  • Phone: 215-337-3433
  • Fax: 215-337-3233
Mailing address:
  • Phone: 267-423-2434
  • 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: NAHLA SALEH
Title or Position: OWNER
Credential:
Phone: 267-423-2434