Provider Demographics
NPI:1457720385
Name:EFFRAIM HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:EFFRAIM HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN MPH
Authorized Official - Phone:215-826-7422
Mailing Address - Street 1:150 MONUMENT RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1725
Mailing Address - Country:US
Mailing Address - Phone:215-826-7422
Mailing Address - Fax:215-239-3038
Practice Address - Street 1:2001A SOUTH JOHN RUSSELL CIRCLE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027
Practice Address - Country:US
Practice Address - Phone:215-826-7422
Practice Address - Fax:215-239-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA28453601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health