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Organization

SE SOULEVER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIE MCMILLER (OWNER)
(724) 312-5777
Entity
Organization

Contact information

Practice address
524 FRANKLIN AVE, ALIQUIPPA, PA 15001-3728
(724) 378-2882
Mailing address
524 FRANKLIN AVE, ALIQUIPPA, PA 15001-3728
(724) 378-2882

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104068643
PA
Enumeration date
02/15/2023
Last updated
02/15/2023
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