Healthcare Provider Details

I. General information

NPI: 1063161263
Provider Name (Legal Business Name): EWELL FAMILY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 SKILES BLVD
WEST CHESTER PA
19382-7381
US

IV. Provider business mailing address

1123 SKILES BLVD
WEST CHESTER PA
19382-7381
US

V. Phone/Fax

Practice location:
  • Phone: 484-757-9593
  • Fax:
Mailing address:
  • Phone: 267-506-7792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHANECE L HAYES-EWELL
Title or Position: OWNER
Credential:
Phone: 484-757-9593