Provider Demographics
NPI:1295180537
Name:RELICARE SERVICE COORDINATION AGENCY LLC
Entity Type:Organization
Organization Name:RELICARE SERVICE COORDINATION AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OREBIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-394-7400
Mailing Address - Street 1:200 BARR HARBOR DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2977
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 BARR HARBOR DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2977
Practice Address - Country:US
Practice Address - Phone:267-394-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-24
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management