Provider Demographics
NPI:1255844601
Name:CHERISHED CONTINUING CARE LLC
Entity Type:Organization
Organization Name:CHERISHED CONTINUING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER/CARE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-975-8965
Mailing Address - Street 1:7867 PROVIDENT RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1322
Mailing Address - Country:US
Mailing Address - Phone:267-975-8965
Mailing Address - Fax:
Practice Address - Street 1:7867 PROVIDENT RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1322
Practice Address - Country:US
Practice Address - Phone:267-975-8965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty