Provider Demographics
NPI:1891390902
Name:SUPPORTIVE CARE RESOURCES
Entity Type:Organization
Organization Name:SUPPORTIVE CARE RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHELLI
Authorized Official - Middle Name:T
Authorized Official - Last Name:GROSE-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-779-3316
Mailing Address - Street 1:1 W BROAD ST FL 11
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5717
Mailing Address - Country:US
Mailing Address - Phone:267-779-3316
Mailing Address - Fax:
Practice Address - Street 1:1 W BROAD ST FL 11
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5717
Practice Address - Country:US
Practice Address - Phone:215-403-7104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care