Healthcare Provider Details

I. General information

NPI: 1104188622
Provider Name (Legal Business Name): ANDREA'S COMPASSIONATE CARE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 CHERRY TREE RD
UPPER CHICHESTER PA
19014-2407
US

IV. Provider business mailing address

PO BOX 2498
BOOTHWYN PA
19061-8498
US

V. Phone/Fax

Practice location:
  • Phone: 610-364-6856
  • 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: MS. ANDREA HAMAN
Title or Position: OWNER/MANAGER
Credential:
Phone: 610-364-6856