Organization
ILLUMINATED HEARTS PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIONNA PERRY (PRESIDENT)
(610) 324-7807
Entity
Organization
Contact information
Practice address
3900 FORD RD, SUITE 104E, PHILADELPHIA, PA 19131-2039
(610) 324-7807
(215) 921-6715
Mailing address
3900 FORD RD, SUITE 104E, PHILADELPHIA, PA 19131-2039
(610) 324-7807
(215) 921-6715
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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