Organization
SHEPHERD'S GATE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL O BANKOLE (ADMINISTRATOR)
(267) 767-3836
Entity
Organization
Contact information
Practice address
501 CENTENNIAL AVE, GILBERTSVILLE, PA 19525-9223
(267) 767-3836
Mailing address
501 CENTENNIAL AVE, GILBERTSVILLE, PA 19525-9223
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN561615
PA
Other
Enumeration date
08/28/2011
Last updated
05/09/2014
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