Provider Demographics
NPI:1528584687
Name:KWENSY200, INC.
Entity Type:Organization
Organization Name:KWENSY200, INC.
Other - Org Name:WELL'S HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:DANSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-948-2905
Mailing Address - Street 1:5 GREAT VALLEY PKWY
Mailing Address - Street 2:STE 339
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 GREAT VALLEY PKWY STE 339
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1426
Practice Address - Country:US
Practice Address - Phone:610-340-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-20
Last Update Date:2017-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA34383601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health