Provider Demographics
NPI:1366705394
Name:ALTRUISTIC HOME CARE AGENCY, LLC
Entity type:Organization
Organization Name:ALTRUISTIC HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GORMAH
Authorized Official - Middle Name:PINKY
Authorized Official - Last Name:KOLLEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-888-4813
Mailing Address - Street 1:2577 NESHAMINY INTERPLEX DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6957
Mailing Address - Country:US
Mailing Address - Phone:215-888-4813
Mailing Address - Fax:215-244-0694
Practice Address - Street 1:2577 NESHAMINY INTERPLEX DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6957
Practice Address - Country:US
Practice Address - Phone:215-888-4813
Practice Address - Fax:215-244-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health