Organization
J30 HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAL-KALEE FERGUSON SR. LBS (CEO)
(267) 767-0662
Entity
Organization
Contact information
Practice address
272 MACDONALD AVE, WYNCOTE, PA 19095-2402
(267) 767-0662
Mailing address
272 MACDONALD AVE, WYNCOTE, PA 19095-2402
(267) 767-0662
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
07/14/2020
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