Healthcare Provider Details

I. General information

NPI: 1285229161
Provider Name (Legal Business Name): EXUBERANCE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 W YORK ST
PHILADELPHIA PA
19133-3037
US

IV. Provider business mailing address

327 W YORK ST
PHILADELPHIA PA
19133-3037
US

V. Phone/Fax

Practice location:
  • Phone: 215-518-7144
  • Fax:
Mailing address:
  • Phone: 215-518-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CHASITY BROWER
Title or Position: OWNER
Credential:
Phone: 215-518-7144