Provider Demographics
NPI:1538538608
Name:GENTLE CARE NURSING SERVICE, INC
Entity type:Organization
Organization Name:GENTLE CARE NURSING SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SPADRINE
Authorized Official - Middle Name:MAVIS
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-927-0958
Mailing Address - Street 1:2479 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1824
Mailing Address - Country:US
Mailing Address - Phone:215-927-0958
Mailing Address - Fax:
Practice Address - Street 1:2479 78TH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1824
Practice Address - Country:US
Practice Address - Phone:215-927-0958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10573601311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home