Provider Demographics
NPI:1679018634
Name:CARING PARTNERS OF PHILADELPHIA HOME CARE. LLC
Entity Type:Organization
Organization Name:CARING PARTNERS OF PHILADELPHIA HOME CARE. LLC
Other - Org Name:CARING PARTNERS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZURAB
Authorized Official - Middle Name:
Authorized Official - Last Name:KVANTRISHVILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-538-0341
Mailing Address - Street 1:1200 BUSTLETON PIKE STE 16A1
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4118
Mailing Address - Country:US
Mailing Address - Phone:267-538-0341
Mailing Address - Fax:215-893-1760
Practice Address - Street 1:1200 BUSTLETON PIKE STE 16A1
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4118
Practice Address - Country:US
Practice Address - Phone:267-538-0341
Practice Address - Fax:215-893-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA31683601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31683601OtherHOME CARE AGENCY LICENSE
PA31683601OtherPENNSYLVANIA DEPARTMENT OF HEALTH