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General NPI Number Information
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NPI Number | 1790235059
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Entity Type | Organization
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Legal Business Name | SIGNATURE HOME CARE LLC
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 5076 MCKEAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4125
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Country | US
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Telephone | 267-423-2157
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 48146
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City | PHILADELPHIA
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State | PA
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Zip | 19144-8146
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Country | US
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Telephone | 267-423-2157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAZMIN RODRIGUEZ
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Credential |
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Telephone | 267-423-2157
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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 | 30923601
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License Number State | PA
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