Healthcare Provider Details

I. General information

NPI: 1992526537
Provider Name (Legal Business Name): WISE HOME CARE WITH COMPASSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N CREIGHTON ST
PHILADELPHIA PA
19139-1505
US

IV. Provider business mailing address

245 N CREIGHTON ST
PHILADELPHIA PA
19139-1505
US

V. Phone/Fax

Practice location:
  • Phone: 267-581-3188
  • Fax:
Mailing address:
  • Phone: 267-581-3188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACEY BURNS
Title or Position: OWNER
Credential:
Phone: 267-581-3188