Organization
PROVISIONAL 2 PREFERRED LIVING 4 EVER 62 INC.
Active
Other names
HomeWell Care Services PA 295
Organization subpart
No
Provider details
NPI number
Authorized official
NINA BAKER (OWNER/OPERATOR)
(267) 235-1839
Entity
Organization
Contact information
Practice address
3300 HENRY AVE APT 210, PHILADELPHIA, PA 19129-1151
(267) 235-1839
Mailing address
711 ARNOLD ST, PHILA, PA 19111-1326
(267) 235-1839
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/22/2025
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