Healthcare Provider Details

I. General information

NPI: 1770446023
Provider Name (Legal Business Name): REYES HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4049 HOWLAND ST
PHILADELPHIA PA
19124-5312
US

IV. Provider business mailing address

4049 HOWLAND ST
PHILADELPHIA PA
19124-5312
US

V. Phone/Fax

Practice location:
  • Phone: 201-879-4318
  • Fax:
Mailing address:
  • Phone: 201-879-4318
  • 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: FIORDALIZA RODRIGUEZ REYES
Title or Position: PRESIDENT
Credential:
Phone: 201-879-4318