Organization
PROACTIVE HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RACHEAL CHRISTIANA BUNDOR LPN (ADMINISTRATOR)
(484) 816-2876
Entity
Organization
Contact information
Practice address
100 E. BROOKHAVEN ROAD, BROOKHAVEN, PA 19015-2310
(484) 816-2876
(484) 540-8391
Mailing address
100 E. BROOKHAVEN ROAD, BROOKHAVEN, PA 19015-2310
(484) 816-2876
(484) 540-8391
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
04900501
PA
251E00000X
Home Health Agency
21453601
PA
253Z00000X
In Home Supportive Care Agency
21453601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04900501
HOME HEALTH AGENCY
PA
05
—
1026281500001
—
PA
Enumeration date
09/02/2011
Last updated
11/03/2014
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