Provider Demographics
NPI:1356887525
Name:GENUINE HEART HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:GENUINE HEART HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:UKAMAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-497-1455
Mailing Address - Street 1:728 JUDIE LN
Mailing Address - Street 2:
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2618
Mailing Address - Country:US
Mailing Address - Phone:347-497-1455
Mailing Address - Fax:267-419-8378
Practice Address - Street 1:1811 BETHLEHEM PIKE STE 211
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-644-7221
Practice Address - Fax:267-419-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA31903601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health