Healthcare Provider Details

I. General information

NPI: 1497242721
Provider Name (Legal Business Name): BALANCE HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 01/24/2022
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 S 60TH ST 1ST FL
PHILADELPHIA PA
19139
US

IV. Provider business mailing address

1553 HERMESPROTA DR
SHARON HILL PA
19079-2424
US

V. Phone/Fax

Practice location:
  • Phone: 215-254-5155
  • Fax: 215-254-5110
Mailing address:
  • Phone: 610-998-5737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number36743601
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number36743601
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number36743601
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number36743601
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number36743601
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number36743601
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number36743601
License Number StatePA
# 9
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number36743601
License Number StatePA

VIII. Authorized Official

Name: MS. ANISA INEZ SHORT
Title or Position: OWNER/PRESIDENT/ADMINISTRATOR
Credential:
Phone: 215-783-1088