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General NPI Number Information
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NPI Number | 1093950164
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Entity Type | Organization
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Legal Business Name | HARGAR SUPREME CARE AND STAFFING, INC.
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 237 WOLFENDEN AVE
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City | COLLINGDALE
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State | PA
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Zip | 19023-3221
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Country | US
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Telephone | 610-237-7467
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Fax | 610-237-7468
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Provider Business Mailing Address
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Address Line | 237 WOLFENDEN AVE
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City | COLLINGDALE
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State | PA
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Zip | 19023-3221
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Country | US
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Telephone | 610-237-7467
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Fax | 610-237-7468
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Authorized Official
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Title or Position | DIRECTOR OF RESIDENTIAL PROGRAM
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Name | MR. GEORGE SADDY HARRIS SR.
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Credential |
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Telephone | 610-237-7467
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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