Organization
NOURISHING CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SIMPSON (ADMINISTRATOR)
(267) 872-6139
Entity
Organization
Contact information
Practice address
4230 GERMANTOWN AVE, PHILADELPHIA, PA 19140-1744
(215) 455-0500
(215) 455-0505
Mailing address
4230 GERMANTOWN AVE, PHILADELPHIA, PA 19140-1744
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103533963001
PROMISE ID NUMBER
PA
Enumeration date
04/16/2019
Last updated
04/16/2019
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