Provider Demographics
NPI:1760022818
Name:AGING AND DISABLE SOCIAL SUPPORT NETWORK
Entity Type:Organization
Organization Name:AGING AND DISABLE SOCIAL SUPPORT NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUBOV
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-939-2414
Mailing Address - Street 1:3272 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4113
Mailing Address - Country:US
Mailing Address - Phone:267-939-2414
Mailing Address - Fax:
Practice Address - Street 1:3272 MANOR RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4113
Practice Address - Country:US
Practice Address - Phone:267-939-2414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health