Organization
FOREVER CARE SUPPORTS COORDINATION LLC
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD UNTHANK-MAY JR. (OWNER)
(267) 340-2556
Entity
Organization
Contact information
Practice address
1706 N 2ND ST # R5, PHILADELPHIA, PA 19122-3110
(267) 340-2556
Mailing address
232 BARTLETT AVE, SHARON HILL, PA 19079-1304
(267) 340-2556
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30811614
—
PA
Enumeration date
04/10/2019
Last updated
04/10/2019
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