Provider Demographics
NPI:1609242908
Name:QUEST COMMUNITY HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:QUEST COMMUNITY HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:DEEN
Authorized Official - Last Name:YANSANE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:215-883-0453
Mailing Address - Street 1:1027 SERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3809
Mailing Address - Country:US
Mailing Address - Phone:215-883-0453
Mailing Address - Fax:
Practice Address - Street 1:747 N 63RD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-3804
Practice Address - Country:US
Practice Address - Phone:215-883-0453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health