Provider Demographics
NPI:1417323510
Name:GREATER LOVE HOME HEALTH CARE INC
Entity type:Organization
Organization Name:GREATER LOVE HOME HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-570-0472
Mailing Address - Street 1:8600 W CHESTER PIKE STE 308
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2629
Mailing Address - Country:US
Mailing Address - Phone:484-454-5529
Mailing Address - Fax:
Practice Address - Street 1:8600 W CHESTER PIKE STE 308
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2629
Practice Address - Country:US
Practice Address - Phone:484-454-5529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health