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General NPI Number Information
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NPI Number | 1861623373
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Entity Type | Organization
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Legal Business Name | HALIA HOME AND COMMUNITY SERVICES
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 320 MACDADE BLVD SUITE 105
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City | COLLINGDALE
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State | PA
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Zip | 19023
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Country | US
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Telephone | 484-494-1355
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Fax | 484-494-1370
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Provider Business Mailing Address
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Address Line | 320 MACDADE BLVD SUITE 105
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City | COLLINGDALE
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State | PA
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Zip | 19023-1927
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Country | US
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Telephone | 484-494-1355
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Fax | 484-494-1370
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JERRY KORLUBAH YOGBOH SR.
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Credential | MS
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Telephone | 267-343-2412
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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 |
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License Number State |
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