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General NPI Number Information
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NPI Number | 1710479019
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Entity Type | Organization
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Legal Business Name | ALLSTAR HEALING HEALTHCARE LLC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 424 S 61ST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1036
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Country | US
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Telephone | 215-727-0727
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Fax | 215-727-0728
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Provider Business Mailing Address
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Address Line | 5703 CHESTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19143-5509
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Country | US
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Telephone | 215-727-0727
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Fax | 215-727-0728
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Authorized Official
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Title or Position | OWNER
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Name | NYEEMA MARTIN
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Credential |
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Telephone | 215-678-6022
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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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