# COMMONWEALTH SUPPORTIVE SERVICES,LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Same as above
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457772808
- **Authorized official:** THOMAS KARGBO (C.E.O.)
- **Authorized official phone:** (267) 207-1941

## Contact information

- **Practice address:** 1602 MACDADE BLVD, FOLSOM, PA 19033-1313
- **Practice address phone:** (267) 207-1941
- **Mailing address:** 1602 MACDADE BLVD, FOLSOM, PA 19033-1313
- **Mailing address phone:** (267) 207-1941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 164W00000X | Licensed Practical Nurse | — | NULL | Yes |
| 164W00000X | Licensed Practical Nurse | — | — | Yes |

## Other

- **Enumeration date:** 01/01/2014
- **Last updated:** 06/27/2016