Healthcare Provider Details
I. General information
NPI: 1801432943
Provider Name (Legal Business Name): URBANCARE HOME CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/25/2019
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 W LEHIGH AVE
PHILADELPHIA PA
19133-3856
US
IV. Provider business mailing address
171 W LEHIGH AVE
PHILADELPHIA PA
19133-3856
US
V. Phone/Fax
- Phone: 267-265-1139
- Fax:
- Phone: 267-585-0212
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
UDAY
GOHEL
Title or Position: PRESIDENT
Credential:
Phone: 267-585-0212