Organization
COMMUCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIAN AKIYA LATIMORE (CHIEF EXECUTIVE OFFICER)
(267) 816-3449
Entity
Organization
Contact information
Practice address
1841 CHURCH LN FL 1, PHILADELPHIA, PA 19141-1319
(267) 816-3449
Mailing address
630 E STAFFORD ST, PHILADELPHIA, PA 19144-1250
(267) 816-3449
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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