Provider Demographics
NPI:1316404585
Name:SIRLEAF, HAWA MAMIE
Entity Type:Individual
Prefix:
First Name:HAWA
Middle Name:MAMIE
Last Name:SIRLEAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 CITY AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2000
Mailing Address - Country:US
Mailing Address - Phone:610-931-0114
Mailing Address - Fax:267-216-7282
Practice Address - Street 1:7708 CITY AVE STE 215
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2000
Practice Address - Country:US
Practice Address - Phone:215-216-7282
Practice Address - Fax:855-300-5348
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA394536013747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA824659990OtherHUMBLE HANDS HOME CARE & STAFFING LLC