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General NPI Number Information
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NPI Number | 1821509613
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Entity Type | Organization
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Legal Business Name | SUDEE HOME CARE, LLC.
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Dates
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Enumeration Date | 10/19/2017
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 821 GARDEN ST
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City | BRISTOL
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State | PA
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Zip | 19007-3912
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Country | US
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Telephone | 267-579-7421
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Fax | 267-579-7421
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Provider Business Mailing Address
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Address Line | 821 GARDEN ST
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City | BRISTOL
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State | PA
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Zip | 19007-3912
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Country | US
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Telephone | 267-579-7421
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Fax |
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | DEETTA TAYLOR
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Credential |
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Telephone | 267-579-7421
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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 | 32943601
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License Number State | PA
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