Organization
IMMENSE PROVIDERS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKEERAH JOHNSON (PRESIDENT)
(267) 259-3957
Entity
Organization
Contact information
Practice address
1 INTERNATIONAL PLZ STE 550, PHILADELPHIA, PA 19113-1528
(672) 593-9572
Mailing address
1 INTERNATIONAL PLZ STE 550, PHILADELPHIA, PA 19113-1528
(215) 617-3839
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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