Provider Demographics
NPI:1013488113
Name:OPTION COMPANION CARE LLC
Entity type:Organization
Organization Name:OPTION COMPANION CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MENA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BASTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-334-8242
Mailing Address - Street 1:1740 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1149
Mailing Address - Country:US
Mailing Address - Phone:610-885-0400
Mailing Address - Fax:610-885-8086
Practice Address - Street 1:1740 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1149
Practice Address - Country:US
Practice Address - Phone:610-885-0400
Practice Address - Fax:610-885-8086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health