Provider Demographics
NPI:1578334157
Name:HEROIC HOME CARE LLC
Entity Type:Organization
Organization Name:HEROIC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONAE
Authorized Official - Middle Name:MARSHAY
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-930-2575
Mailing Address - Street 1:139 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-2332
Mailing Address - Country:US
Mailing Address - Phone:215-930-2575
Mailing Address - Fax:
Practice Address - Street 1:139 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:19018-2332
Practice Address - Country:US
Practice Address - Phone:215-930-2575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care