Healthcare Provider Details

I. General information

NPI: 1629989637
Provider Name (Legal Business Name): ECHELON HOLDINGS I LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 WHARTON ST FL 1
PHILADELPHIA PA
19146-3528
US

IV. Provider business mailing address

3012 WHARTON ST FL 1
PHILADELPHIA PA
19146-3528
US

V. Phone/Fax

Practice location:
  • Phone: 215-520-2838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RAY TRAN
Title or Position: MANAGER
Credential:
Phone: 215-520-2838