Organization
CORDOVA CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEI OU (PRESIDENT/TREASURER)
(267) 808-1970
Entity
Organization
Contact information
Practice address
2122 WALLACE ST, PHILADELPHIA, PA 19130-3105
(267) 808-1970
Mailing address
2122 WALLACE ST, PHILADELPHIA, PA 19130-3105
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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