MEDICARE: HELPING INDIVIDUALS SUCCEED 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103179192	OTHER	PA	MASTER PATIENT INDEX (MPI)

General Provider Information

NPI Number	:	1255957650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING INDIVIDUALS SUCCEED LLC

Provider Business Mailing Address
First Line	:	4950 PARKSIDE AVE STE 101
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-4724
Country	:	US
Telephone Number	:	267-455-0599
Fax Number	:	267-455-0744

Provider Business Practice Location Address
First Line	:	4950 PARKSIDE AVE STE 101
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-4724
Country	:	US
Telephone Number	:	267-455-0599
Fax Number	:	267-455-0744

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JENNIFER SHIELDS
Credential	:
Telephone Number	:	267-455-0599

Provider Enumeration Date	:	06/22/2020
Last Update Date	:	06/22/2020

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