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General NPI Number Information
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NPI Number | 1043023484
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Entity Type | Organization
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Legal Business Name | DDS PREFERRED HOME CARE AGENCY
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 55 S PROGRESS AVE STE 2
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City | HARRISBURG
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State | PA
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Zip | 17109-4600
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Country | US
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Telephone | 223-207-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 55 S PROGRESS AVE STE 2
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City | HARRISBURG
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State | PA
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Zip | 17109-4600
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Country | US
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Telephone | 223-207-3417
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DORETHA SHANTE DONALD
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Credential |
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Telephone | 717-614-7812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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