Provider Demographics
NPI:1043372386
Name:VICTORIAS' HOME CARE, LLC
Entity Type:Organization
Organization Name:VICTORIAS' HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUNLEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-544-3037
Mailing Address - Street 1:630 FAIRVIEW RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2334
Mailing Address - Country:US
Mailing Address - Phone:610-544-3037
Mailing Address - Fax:610-544-4752
Practice Address - Street 1:630 FAIRVIEW RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2334
Practice Address - Country:US
Practice Address - Phone:610-544-3037
Practice Address - Fax:610-544-4752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02280501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009346550001Medicaid
PA1009346550002Medicaid