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General NPI Number Information
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NPI Number | 1609472356
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Entity Type | Organization
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Legal Business Name | ADVANCE HOME HEALTH LLC
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 1117 BROADWAY AVE
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City | SECANE
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State | PA
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Zip | 19018-2029
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Country | US
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Telephone | 484-461-3950
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Fax | 484-461-3950
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Provider Business Mailing Address
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Address Line | 1117 BROADWAY AVE
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City | SECANE
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State | PA
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Zip | 19018-2029
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Country | US
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Telephone | 484-461-3950
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Fax | 484-461-3950
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMED L SESAY
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Credential | RN
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Telephone | 484-461-3950
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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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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care 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 | 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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