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General NPI Number Information
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NPI Number | 1861865818
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Entity Type | Organization
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Legal Business Name | DISTINCT HOME HEALTH CARE, LLC.
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 8900 MAXWELL PL.
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City | PHILADELPHIA
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State | PA
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Zip | 19152
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Country | US
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Telephone | 215-713-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 MAXWELL PL.
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City | PHILADELPHIA
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State | PA
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Zip | 19152
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Country | US
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Telephone | 215-713-5413
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Fax |
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Authorized Official
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Title or Position | RN, BSN DIRECTOR
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Name | MISS GLADYS CHARLEMAGNE
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Credential | BSN, RN - REGISTERED
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Telephone | 215-713-5413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | RN:625738
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN:625738
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License Number State | PA
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