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General NPI Number Information
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NPI Number | 1821311747
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Entity Type | Organization
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Legal Business Name | GENTLE CARE NURSING SERVICE INC.
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 2479 78TH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1824
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Country | US
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Telephone | 215-927-0958
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Fax | 215-424-3489
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Provider Business Mailing Address
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Address Line | 2479 78TH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1824
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Country | US
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Telephone | 215-927-0958
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Fax | 215-424-3489
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SPADRINE MAVIS CLARKE
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Credential |
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Telephone | 215-927-0958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 179657
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License Number State | PA
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