Provider Demographics
NPI:1942599774
Name:UNICARE FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:UNICARE FAMILY SERVICES, INC.
Other - Org Name:UNICARE FAMILY SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXE. DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:ANYAEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:267-292-2647
Mailing Address - Street 1:6521 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2816
Mailing Address - Country:US
Mailing Address - Phone:267-292-2647
Mailing Address - Fax:267-292-2657
Practice Address - Street 1:6521 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2816
Practice Address - Country:US
Practice Address - Phone:267-292-2647
Practice Address - Fax:267-292-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1023400690010163WC1500X, 164W00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023400690010OtherODP