Provider Demographics
NPI:1669074118
Name:SPENCER HOME CARE LLC
Entity type:Organization
Organization Name:SPENCER HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-992-2294
Mailing Address - Street 1:1 INTERNATIONAL PLZ STE 513
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19113-1510
Mailing Address - Country:US
Mailing Address - Phone:484-493-7751
Mailing Address - Fax:
Practice Address - Street 1:1 INTERNATIONAL PLZ STE 513
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19113-1510
Practice Address - Country:US
Practice Address - Phone:484-493-7751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care