Organization
INDEPENDENCE CARE OF PHILADELPHIA, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP VIAR (ADMINISTRATOR)
(267) 405-4686
Entity
Organization
Contact information
Practice address
3330 N FRONT ST, PHILADELPHIA, PA 19140-5808
(267) 405-4686
Mailing address
517 W SADDLE RIVER RD, UPPER SADDLE RIVER, NJ 07458-1138
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103614776-0001
—
PA
Enumeration date
05/22/2019
Last updated
11/30/2020
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