MEDICARE: REIS LIFE HOME CARE, INC.

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1215629423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REIS LIFE HOME CARE, INC.

Provider Business Mailing Address
First Line	:	4711 WELLINGTON ST STE B
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-1320
Country	:	US
Telephone Number	:	215-653-8902
Fax Number	:	215-653-8902

Provider Business Practice Location Address
First Line	:	4711 WELLINGTON ST STE B
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-1320
Country	:	US
Telephone Number	:	215-653-8902
Fax Number	:	215-653-8902

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ROMAN SHPIGEL
Credential	:
Telephone Number	:	215-653-8902

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	05/31/2023

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