Healthcare Provider Details

I. General information

NPI: 1679174585
Provider Name (Legal Business Name): REPUTABLE SOLUTIONS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E PRICE ST
PHILADELPHIA PA
19138-1806
US

IV. Provider business mailing address

1005 E PRICE ST
PHILADELPHIA PA
19138-1806
US

V. Phone/Fax

Practice location:
  • Phone: 267-709-3766
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANDRA LANE
Title or Position: PRESIDENT
Credential:
Phone: 267-709-3766