Provider Demographics
NPI:1659022358
Name:GREENLEAFHOMECARES
Entity Type:Organization
Organization Name:GREENLEAFHOMECARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:DORCAS
Authorized Official - Middle Name:OLUWATOYIN
Authorized Official - Last Name:FABODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-375-8298
Mailing Address - Street 1:5911 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-3810
Mailing Address - Country:US
Mailing Address - Phone:215-375-8298
Mailing Address - Fax:
Practice Address - Street 1:5911 CHARLES ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-3810
Practice Address - Country:US
Practice Address - Phone:215-375-8298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care