Organization
WATERSHED AND ARK OF SALVATION MINISTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA EBUN OGUNLOKUN (ADMINISTRATOR)
(267) 575-0858
Entity
Organization
Contact information
Practice address
5265 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-1720
(267) 575-0858
Mailing address
5265 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-1720
(267) 575-0858
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
33853601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33853601
HOME CARE AGENCY
PA
Enumeration date
07/25/2017
Last updated
07/21/2022
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