Healthcare Provider Details

I. General information

NPI: 1891421889
Provider Name (Legal Business Name): WILMINATA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2243 S FELTON ST
PHILADELPHIA PA
19142-2305
US

IV. Provider business mailing address

2206 NASSAU DR
WILMINGTON DE
19810-2831
US

V. Phone/Fax

Practice location:
  • Phone: 267-495-6799
  • Fax: 215-397-4196
Mailing address:
  • Phone: 267-495-6799
  • Fax: 215-397-4196

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: HAWANATU KONTEH
Title or Position: OWNER, PRESIDENT
Credential:
Phone: 267-495-6799