Healthcare Provider Details

I. General information

NPI: 1336980119
Provider Name (Legal Business Name): SAFE HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 CAMPBELL ST
SCRANTON PA
18505-3403
US

IV. Provider business mailing address

617 CAMPBELL ST
SCRANTON PA
18505-3403
US

V. Phone/Fax

Practice location:
  • Phone: 570-281-0321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BHAKTA GHALLEY
Title or Position: DIRECTOR
Credential:
Phone: 315-237-0329