Organization
YOUR INDEPENDENCE HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEKIA JOHNSON (OWNER)
(267) 831-7032
Entity
Organization
Contact information
Practice address
616 ALCOTT ST, PHILADELPHIA, PA 19120-1220
(267) 831-7032
Mailing address
616 ALCOTT ST, PHILADELPHIA, PA 19120-1220
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52943601
DEPARTMENT OF HEALTH
PA
Enumeration date
02/05/2021
Last updated
02/05/2021
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