Provider Demographics
NPI:1346057338
Name:FOREVER AGING HOME CARE LLC
Entity type:Organization
Organization Name:FOREVER AGING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROKEISH
Authorized Official - Middle Name:
Authorized Official - Last Name:STUPART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-604-5066
Mailing Address - Street 1:742 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-1336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:742 POPLAR ST
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-1336
Practice Address - Country:US
Practice Address - Phone:240-604-5066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health