Healthcare Provider Details

I. General information

NPI: 1073172169
Provider Name (Legal Business Name): BY YOUR SIDE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 W ZERALDA ST
PHILADELPHIA PA
19144-4212
US

IV. Provider business mailing address

245 W ZERALDA ST
PHILADELPHIA PA
19144-4212
US

V. Phone/Fax

Practice location:
  • Phone: 267-252-5331
  • Fax:
Mailing address:
  • Phone: 267-252-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLE TAYLOR
Title or Position: OWNER
Credential:
Phone: 267-252-5331