Provider Demographics
NPI:1609128305
Name:JIREH HOMEHEALTH AGENCY
Entity Type:Organization
Organization Name:JIREH HOMEHEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-735-7702
Mailing Address - Street 1:1315 WALNUT ST
Mailing Address - Street 2:SUITE 1326
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4719
Mailing Address - Country:US
Mailing Address - Phone:215-735-7702
Mailing Address - Fax:215-735-7703
Practice Address - Street 1:1315 WALNUT ST
Practice Address - Street 2:SUITE 1326
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4719
Practice Address - Country:US
Practice Address - Phone:215-735-7702
Practice Address - Fax:215-735-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health