Provider Demographics
NPI:1588104988
Name:ATTENTIVE CARE SERVICE AGENCY, INC.
Entity type:Organization
Organization Name:ATTENTIVE CARE SERVICE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:WAKILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEEM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-449-4956
Mailing Address - Street 1:5070 PARKSIDE AVE STE 1421
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4748
Mailing Address - Country:US
Mailing Address - Phone:215-477-2100
Mailing Address - Fax:215-477-2300
Practice Address - Street 1:5070 PARKSIDE AVE STE 1421
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-477-2100
Practice Address - Fax:215-477-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3306301253Z00000X, 251E00000X
PA33063601385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care