MEDICARE: KINDRED HOME HEALTH SERVICES 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

General Provider Information

NPI Number	:	1720431505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDRED HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1420 WALNUT ST STE 1207
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 WALNUT ST STE 1207
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4012
Country	:	US
Telephone Number	:	610-333-3694
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICE SEALS
Credential	:
Telephone Number	:	610-333-3694

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	07/18/2016

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