Healthcare Provider Details

I. General information

NPI: 1154692044
Provider Name (Legal Business Name): CLP HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2722 N RINGGOLD ST
PHILADELPHIA PA
19132-3208
US

IV. Provider business mailing address

204 STEVENS ST
PHILADELPHIA PA
19111-5917
US

V. Phone/Fax

Practice location:
  • Phone: 215-221-6060
  • Fax:
Mailing address:
  • Phone: 215-459-2733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberPN093291L
License Number StatePA

VIII. Authorized Official

Name: MRS. PAMELA E TAYLOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 215-459-2733