Provider Demographics
NPI:1992212468
Name:NEW WAY OF LIFE 2 HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:NEW WAY OF LIFE 2 HOME HEALTH CARE AGENCY LLC
Other - Org Name:NEW WAY OF LIFE HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:KEVICHE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-910-6362
Mailing Address - Street 1:6145 ERDRICK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-3516
Mailing Address - Country:US
Mailing Address - Phone:215-910-6362
Mailing Address - Fax:
Practice Address - Street 1:2145 N 22ND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-1401
Practice Address - Country:US
Practice Address - Phone:215-763-7077
Practice Address - Fax:215-763-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA35583601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health