MEDICARE: NUOVO RESIDENTIAL ASSISTED LIVING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251S00000X	Community/Behavioral Health Agency
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1609681782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUOVO RESIDENTIAL ASSISTED LIVING

Provider Business Mailing Address
First Line	:	5610 ADDISON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-1308
Country	:	US
Telephone Number	:	484-522-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	6419 CARLTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-1013
Country	:	US
Telephone Number	:	484-522-1111
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARCIA GBATU
Credential	:
Telephone Number	:	484-522-1111

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	01/21/2026

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Directions to “NUOVO RESIDENTIAL ASSISTED LIVING ” Practice Location

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