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General NPI Number Information
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NPI Number | 1225548902
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Entity Type | Organization
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Legal Business Name | PAULINE'S HOME CARE & MANAGEMENT SERVICES, INC.
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 12 W WILLOW GROVE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-3952
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Country | US
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Telephone | 267-422-3950
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Fax | 215-543-3344
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Provider Business Mailing Address
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Address Line | 901 E PLEASANT AVE APT 6A
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City | WYNDMOOR
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State | PA
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Zip | 19038-8039
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Country | US
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Telephone | 267-584-2852
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JACKLYNN B JOHNSON
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Credential |
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Telephone | 267-422-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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