Organization
PHILADELPHIA LIVES MATTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY WILLIAMS (ADMINISTRATOR)
(267) 265-4670
Entity
Organization
Contact information
Practice address
8500 LINDBERGH BLVD APT 1807, PHILADELPHIA, PA 19153-1521
(267) 265-4670
Mailing address
8500 LINDBERGH BLVD APT 1807, PHILADELPHIA, PA 19153-1521
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103846921
—
PA
Enumeration date
03/24/2021
Last updated
03/24/2021
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