Provider Demographics
NPI:1346243763
Name:PREFERRED HOME CARE
Entity Type:Organization
Organization Name:PREFERRED HOME CARE
Other - Org Name:IN HOME PROGRAM/PREFERRED HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HESSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-763-2265
Mailing Address - Street 1:741 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2539
Mailing Address - Country:US
Mailing Address - Phone:215-763-2265
Mailing Address - Fax:215-763-3417
Practice Address - Street 1:741 N 24TH ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19130-2539
Practice Address - Country:US
Practice Address - Phone:215-763-2265
Practice Address - Fax:215-763-3417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA758805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000574000OtherPERSONAL CHOICE
PA0009024000OtherPERSONAL CHOICE
PA0014639560002Medicaid
NJ0151661Medicaid
PA2135255OtherAETNA
PA30789OtherHEALTH PARTNERS
PA1029648OtherKEYSTONE MERCY HEALTH PLA
PA0000574000OtherKEYSTONE HEALTH PLAN EAST
PA0001437000OtherINDEPENDENCE BLUE CROSS
PA101879262001Medicaid
PA0009024000OtherKEYSTONE HEALTH PLAN EAST
PA0146395602OtherAMERICHOICE OF PA
NJ0151661Medicaid