Provider Demographics
NPI:1417577214
Name:JOSINIA SENIOR HOME CARE
Entity Type:Organization
Organization Name:JOSINIA SENIOR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:215-970-5764
Mailing Address - Street 1:152 MONROE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PENNDEL
Mailing Address - State:PA
Mailing Address - Zip Code:19047-4026
Mailing Address - Country:US
Mailing Address - Phone:215-970-5764
Mailing Address - Fax:267-358-5038
Practice Address - Street 1:152 MONROE AVE STE 205
Practice Address - Street 2:
Practice Address - City:PENNDEL
Practice Address - State:PA
Practice Address - Zip Code:19047-4026
Practice Address - Country:US
Practice Address - Phone:215-970-5764
Practice Address - Fax:267-358-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care