Provider Demographics
NPI:1609548130
Name:PRIVATE LEVEL LLC
Entity Type:Organization
Organization Name:PRIVATE LEVEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHAKEEM MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-778-2261
Mailing Address - Street 1:2901 W. LEHIGH AVENUE APT. 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132
Mailing Address - Country:US
Mailing Address - Phone:215-778-2261
Mailing Address - Fax:
Practice Address - Street 1:2901 W. LEHIGH AVENUE APT. 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132
Practice Address - Country:US
Practice Address - Phone:215-778-2261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-03
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management