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General NPI Number Information
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NPI Number | 1992668602
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Entity Type | Organization
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Legal Business Name | EBENEZER HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3525 I ST STE 307
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1455
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Country | US
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Telephone | 215-495-3369
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Fax |
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Provider Business Mailing Address
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Address Line | 3525 I ST STE 307
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1455
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Country | US
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Telephone | 215-495-3369
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LIZMAR ENCARNACION-ROSARIO
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Credential |
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Telephone | 215-495-3369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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