Provider Demographics
NPI:1700166816
Name:PERSON-CENTERED HOME & COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:PERSON-CENTERED HOME & COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MBA
Authorized Official - Phone:215-432-5446
Mailing Address - Street 1:1720 MEMORIAL AVE
Mailing Address - Street 2:3
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-1018
Mailing Address - Country:US
Mailing Address - Phone:215-432-5446
Mailing Address - Fax:
Practice Address - Street 1:1720 MEMORIAL AVE
Practice Address - Street 2:3
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-1018
Practice Address - Country:US
Practice Address - Phone:215-432-5446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21753601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care