Organization
PREFERRED GERIATRIC HEALTH CARE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE ORISHA BOURNE (CEO)
(215) 551-5620
Entity
Organization
Contact information
Practice address
272 S 56TH ST, PHILA, PA 19139-3903
(215) 551-5620
(215) 474-4850
Mailing address
272 S 56TH ST, PHILADELPHIA, PA 19139-3903
(215) 551-5620
(215) 474-4850
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
23573601
PA
251E00000X
Home Health Agency
Primary
23573601
PA
251K00000X
Public Health or Welfare Agency
23573601
PA
251S00000X
Community/Behavioral Health Agency
23573601
PA
251V00000X
Voluntary or Charitable Agency
23573601
PA
253J00000X
Foster Care Agency
23573601
PA
3104A0625X
Assisted Living Facility (Mental Illness)
23573601
PA
310500000X
Mental Illness Intermediate Care Facility
23573601
PA
311ZA0620X
Adult Care Home Facility
23573601
PA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
23573601
PA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
23573601
PA
3245S0500X
Children's Substance Abuse Rehabilitation Facility
23573601
PA
385HR2055X
Child Mental Illness Respite Care
23573601
PA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
23573601
PA
385HR2065X
Child Physical Disabilities Respite Care
23573601
PA
Other
Enumeration date
02/13/2013
Last updated
10/08/2013
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