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General NPI Number Information
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NPI Number | 1265054977
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR 2 HOME CARE AGENCY, LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 2418 N 15TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19132-4435
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Country | US
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Telephone | 215-430-3032
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Fax |
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Provider Business Mailing Address
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Address Line | 2418 N 15TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19132-4435
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Country | US
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Telephone | 215-430-3032
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHIQUITA MCGOUGH
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Credential |
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Telephone | 215-430-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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