Organization
BLUE RIDGE HOME CARE, INC
Active
Other names
Blue Ridge Home Health Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
TUNJI OGUNMOLA MSW (PRESIDENT)
(215) 457-4950
Entity
Organization
Contact information
Practice address
1310 W ROOSEVELT BLVD, PHILADELPHIA, PA 19140-2033
(215) 457-4950
(215) 329-8808
Mailing address
1310 W ROOSEVELT BLVD, PHILADELPHIA, PA 19140-2033
(215) 457-4950
(215) 329-8808
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
04800501
PA
251E00000X
Home Health Agency
04800501
PA
251E00000X
Home Health Agency
23033601
PA
251J00000X
Nursing Care Agency
04800501
PA
253Z00000X
In Home Supportive Care Agency
04800501
PA
253Z00000X
In Home Supportive Care Agency
Primary
23033601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04800501
HOME HEALTHCARE LICENSE
PA
05
—
102817836
—
PA
01
—
23033601
HOME CARE LICENSE
PA
Enumeration date
10/22/2013
Last updated
09/02/2025
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