Provider Demographics
NPI:1639760341
Name:PEABODY'S IN HOME ANGELS LLC
Entity Type:Organization
Organization Name:PEABODY'S IN HOME ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNISHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-836-2366
Mailing Address - Street 1:1830 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19061-2722
Mailing Address - Country:US
Mailing Address - Phone:610-836-2366
Mailing Address - Fax:
Practice Address - Street 1:910 CLOVER LN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-1619
Practice Address - Country:US
Practice Address - Phone:610-836-2366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care