Organization
IMMANUEL CARE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HAWA A KAMARA (PRESIDENT/CEO)
(267) 403-8313
Entity
Organization
Contact information
Practice address
6641 DOREL ST, PHILADELPHIA, PA 19142-2618
(267) 403-8313
Mailing address
6641 DOREL ST, PHILADELPHIA, PA 19142-2618
(267) 403-8313
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
PA
253Z00000X
In Home Supportive Care Agency
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4345180
—
PA
Enumeration date
04/22/2015
Last updated
04/30/2015
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