Healthcare Provider Details

I. General information

NPI: 1689207524
Provider Name (Legal Business Name): SERAY HOMECARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 N 52ND ST
PHILADELPHIA PA
19139-1549
US

IV. Provider business mailing address

342 N 52ND ST
PHILADELPHIA PA
19139-1549
US

V. Phone/Fax

Practice location:
  • Phone: 267-495-6799
  • Fax:
Mailing address:
  • Phone: 267-495-6799
  • 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: HAWANATU KONTEH
Title or Position: PRESIDENT
Credential:
Phone: 267-495-6799