Organization
PROVISIONS HOME HEALTHCARE SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CLERISSON RN BSN (ADMINISTRATOR)
(215) 399-9766
Entity
Organization
Contact information
Practice address
10067 SANDMEYER LN, SUITE 212, PHILADELPHIA, PA 19116-3533
(215) 399-9766
Mailing address
10067 SANDMEYER LN, SUITE 212, PHILADELPHIA, PA 19116-3533
(215) 399-9766
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
30023601
PA
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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