Provider Demographics
NPI:1619409034
Name:BLUE EMERALD PORTFOLIOS LLC
Entity Type:Organization
Organization Name:BLUE EMERALD PORTFOLIOS LLC
Other - Org Name:CATALYST CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:THEMBISILE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASEKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-4761
Mailing Address - Street 1:1308 MINUTEMEN LN
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-6318
Mailing Address - Country:US
Mailing Address - Phone:240-486-4761
Mailing Address - Fax:
Practice Address - Street 1:1308 MINUTEMEN LN
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-6318
Practice Address - Country:US
Practice Address - Phone:240-486-4761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUE EMERALD PORTFOLIOS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health