MEDICARE: A SHELTERING EMBRACE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003447970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A SHELTERING EMBRACE, LLC

Provider Business Mailing Address
First Line	:	229 LARDNER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5907
Country	:	US
Telephone Number	:	215-278-1299
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 LARDNER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5907
Country	:	US
Telephone Number	:	215-278-1299
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. DAMARIS DIAZ
Credential	:
Telephone Number	:	215-278-1299

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	01/30/2020

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