Individual
SHAMIKA ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5906 CRYSTAL ST, PHILADELPHIA, PA 19120-1128
(267) 334-7951
Mailing address
5906 CRYSTAL ST, PHILADELPHIA, PA 19120-1128
(267) 334-7951
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
67813601
PA
376J00000X
Homemaker
67813601
PA
385H00000X
Respite Care
67813601
PA
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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