MEDICARE: MEGA CARE 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1770947533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGA CARE LLC

Provider Business Mailing Address
First Line	:	2707 S 86TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153
Country	:	US
Telephone Number	:	215-869-4937
Fax Number	:	215-869-4937

Provider Business Practice Location Address
First Line	:	2707 S 86TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153
Country	:	US
Telephone Number	:	215-869-4937
Fax Number	:	215-869-4937

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. VICTORIA NKECHI UGWU
Credential	:
Telephone Number	:	215-869-4937

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	04/07/2016

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Directions to “MEGA CARE LLC ” Practice Location

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