Organization
ALYOSHA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY JOHNSON (PRESIDENT)
(610) 609-9460
Entity
Organization
Contact information
Practice address
615 ANDOVER RD, UPPER DARBY, PA 19082-5203
(610) 609-9460
Mailing address
PO BOX 2308, UPPER DARBY, PA 19082-0808
(610) 609-9460
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6505676
SECRETARY OF STATE ENTITY NUMBER
PA
Enumeration date
12/17/2019
Last updated
12/17/2019
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