# FOREVER CARE SUPPORTS COORDINATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** N/A
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043773633
- **Authorized official:** MR. TODD UNTHANK-MAY JR. (OWNER)
- **Authorized official phone:** (267) 340-2556

## Contact information

- **Practice address:** 1706 N 2ND ST \# R5, PHILADELPHIA, PA 19122-3110
- **Practice address phone:** (267) 340-2556
- **Mailing address:** 232 BARTLETT AVE, SHARON HILL, PA 19079-1304
- **Mailing address phone:** (267) 340-2556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 174200000X | Meals Provider | — | NULL | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 04/10/2019
- **Last updated:** 04/10/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30811614 | — | PA |