MEDICARE: GREENLEAFHOMECARES

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

General Provider Information

NPI Number	:	1659022358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENLEAFHOMECARES

Provider Business Mailing Address
First Line	:	5911 CHARLES ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3810
Country	:	US
Telephone Number	:	215-375-8298
Fax Number	:

Provider Business Practice Location Address
First Line	:	5911 CHARLES ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-3810
Country	:	US
Telephone Number	:	215-375-8298
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	DORCAS OLUWATOYIN FABODE
Credential	:
Telephone Number	:	215-375-8298

Provider Enumeration Date	:	01/13/2022
Last Update Date	:	01/13/2022

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Directions to “GREENLEAFHOMECARES ” Practice Location

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