Provider Demographics
NPI:1689357329
Name:RELATIVE CARE AT HOME AGENCY LLC
Entity Type:Organization
Organization Name:RELATIVE CARE AT HOME AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-870-0717
Mailing Address - Street 1:1200 E HIGH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-4954
Mailing Address - Country:US
Mailing Address - Phone:215-870-0717
Mailing Address - Fax:
Practice Address - Street 1:2015 N MASTERS DR STE 216
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-3188
Practice Address - Country:US
Practice Address - Phone:215-870-0717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty