Provider Demographics
NPI:1629526751
Name:BLESSED AGE HELPERS-BAH
Entity Type:Organization
Organization Name:BLESSED AGE HELPERS-BAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARLEY
Authorized Official - Middle Name:MOMODOU
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-660-5556
Mailing Address - Street 1:1305 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-2206
Mailing Address - Country:US
Mailing Address - Phone:866-660-5556
Mailing Address - Fax:
Practice Address - Street 1:1305 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-2206
Practice Address - Country:US
Practice Address - Phone:866-660-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA31373601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31373601OtherDEPARTMENT OF HEALTH
PA3137Medicare PIN