Healthcare Provider Details

I. General information

NPI: 1891332086
Provider Name (Legal Business Name): ACCESS CARE HUMAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2019
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 E WOODLAND AVE STE 216
SPRINGFIELD PA
19064-3969
US

IV. Provider business mailing address

1260 E WOODLAND AVE STE 216
SPRINGFIELD PA
19064-3969
US

V. Phone/Fax

Practice location:
  • Phone: 484-472-8702
  • Fax:
Mailing address:
  • Phone: 484-472-8702
  • Fax: 484-472-8755

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

VIII. Authorized Official

Name: HENRY S KOLLIE JR.
Title or Position: OWNER
Credential:
Phone: 267-319-6952