Healthcare Provider Details

I. General information

NPI: 1689796526
Provider Name (Legal Business Name): VILLAGE CARE FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 PARKSIDE AVE 5TH FLOOR
PHILADELPHIA PA
19131-4746
US

IV. Provider business mailing address

4950 PARKSIDE AVE 5TH FLOOR
PHILADELPHIA PA
19131-4746
US

V. Phone/Fax

Practice location:
  • Phone: 215-879-4023
  • Fax: 215-879-3405
Mailing address:
  • Phone: 215-879-4023
  • Fax: 215-879-3405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOETTA MORAN KERSEY SR.
Title or Position: CEO DIRECTOR
Credential: SLP
Phone: 215-879-4023