Healthcare Provider Details

I. General information

NPI: 1437748704
Provider Name (Legal Business Name): GOOD STEWARD HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 KING OF PRUSSIA RD STE 650
RADNOR PA
19087-5156
US

IV. Provider business mailing address

201 KING OF PRUSSIA RD STE 650
RADNOR PA
19087-5156
US

V. Phone/Fax

Practice location:
  • Phone: 215-260-6211
  • Fax:
Mailing address:
  • Phone: 215-260-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. SONYA YVETTE FORD
Title or Position: CEO
Credential:
Phone: 215-260-6211