Organization
DIVERSIFIED SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RASHEEN H BEARD (MANAGER)
(215) 673-2778
Entity
Organization
Contact information
Practice address
9200 OLD BUSTLETON AVE, SUITE D-207, PHILA, PA 19115-4642
(215) 673-2778
(215) 673-2778
Mailing address
PO BOX 45923, PHILA, PA 19149-5923
(215) 673-2778
(215) 673-2778
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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