Organization
CYNDRAANITA WILSON HOMECARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNDRAANITA WILSON (ADMINISTRATOR)
(215) 237-6439
Entity
Organization
Contact information
Practice address
1140 S 15TH ST, PHILADELPHIA, PA 19146-3141
(215) 545-2273
Mailing address
1140 S 15TH ST, PHILADELPHIA, PA 19146-3141
(215) 545-2273
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103944950-0001
—
PA
Enumeration date
08/06/2022
Last updated
08/06/2022
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