Provider Demographics
NPI:1952854515
Name:PRIDE N AGING HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:PRIDE N AGING HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EZINWA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:770-949-8332
Mailing Address - Street 1:707 E UNION ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4937
Mailing Address - Country:US
Mailing Address - Phone:678-983-3439
Mailing Address - Fax:
Practice Address - Street 1:707 E UNION ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4937
Practice Address - Country:US
Practice Address - Phone:678-983-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric