Provider Demographics
NPI:1720081680
Name:IN HOME PROGRAM, INC.
Entity Type:Organization
Organization Name:IN HOME PROGRAM, INC.
Other - Org Name:MARSCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:BA, RN, CCRN
Authorized Official - Phone:215-763-3992
Mailing Address - Street 1:739 N. 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130
Mailing Address - Country:US
Mailing Address - Phone:215-232-4357
Mailing Address - Fax:215-763-0708
Practice Address - Street 1:739 N. 24TH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130
Practice Address - Country:US
Practice Address - Phone:215-232-4357
Practice Address - Fax:215-763-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA758805251E00000X
PA397588251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014639560002Medicaid
PA39-7588Medicare ID - Type UnspecifiedHOME HEALTH AGENCY