Provider Demographics
NPI:1679186456
Name:NOBILITY HOME CARE LLC
Entity Type:Organization
Organization Name:NOBILITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DACRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-261-1216
Mailing Address - Street 1:173 W TABOR RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2931
Mailing Address - Country:US
Mailing Address - Phone:267-261-1216
Mailing Address - Fax:
Practice Address - Street 1:173 W TABOR RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-2931
Practice Address - Country:US
Practice Address - Phone:267-261-1216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health