| Immanuel Care Support Services | |
|
6641 Dorel St Philadelphia PA 19142-2618 | |
| (267) 403-8313 | |
| Not Available |
| Full Name | Immanuel Care Support Services |
|---|---|
| Speciality | In Home Supportive Care |
| Location | 6641 Dorel St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Hawa A Kamara (PRESIDENT/CEO) |
| Authorized Official Contact | 2674038313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immanuel Care Support Services 6641 Dorel St Philadelphia PA 19142-2618 Ph: (267) 403-8313 | Immanuel Care Support Services 6641 Dorel St Philadelphia PA 19142-2618 Ph: (267) 403-8313 |
| NPI Number | 1003203571 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 04/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003203571 | NPI | - | NPPES |
| 4345180 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Pennsylvania) | Secondary |
| 253Z00000X | In Home Supportive Care | (Pennsylvania) | Primary |
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