Provider Demographics
NPI:1699472845
Name:SPECIAL TOUCHES HOME CARE
Entity type:Organization
Organization Name:SPECIAL TOUCHES HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOZER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:267-624-5653
Mailing Address - Street 1:2600 WELSH RD APT 49
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-1442
Mailing Address - Country:US
Mailing Address - Phone:267-624-5653
Mailing Address - Fax:
Practice Address - Street 1:1437 JEROME ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-3015
Practice Address - Country:US
Practice Address - Phone:267-936-1268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1041005170001Medicaid