Provider Demographics
NPI:1063876977
Name:TWIN OAKS INTEGRATED CARE
Entity type:Organization
Organization Name:TWIN OAKS INTEGRATED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL SUPERVISIOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAREEMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-474-5413
Mailing Address - Street 1:1525 TRIBBETT AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-2431
Mailing Address - Country:US
Mailing Address - Phone:267-474-5413
Mailing Address - Fax:
Practice Address - Street 1:1525 TRIBBETT AVE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-2431
Practice Address - Country:US
Practice Address - Phone:267-474-5413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care