Healthcare Provider Details

I. General information

NPI: 1508418948
Provider Name (Legal Business Name): DOUBLE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900-14 COTTMAN AVE
PHILADELPHIA PA
19149
US

IV. Provider business mailing address

2846 SAINT VINCENT ST
PHILADELPHIA PA
19149-1414
US

V. Phone/Fax

Practice location:
  • Phone: 215-618-9888
  • Fax:
Mailing address:
  • Phone: 215-618-9888
  • Fax: 215-725-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: XIAO RONG LI
Title or Position: DIRECTOR
Credential:
Phone: 215-618-9888