Organization
DIVERSIFIED SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RASHEEN BETHEL (CEO)
(215) 673-2778
Entity
Organization
Contact information
Practice address
1714 MEMPHIS ST, SUITE C-8, PHILADELPHIA, PA 19125-2700
(215) 673-2778
(215) 673-3451
Mailing address
1714 MEMPHIS ST, SUITE C-8, PHILADELPHIA, PA 19125-2700
(215) 673-2778
(215) 673-3451
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
383203
PA
251E00000X
Home Health Agency
16723601
PA
Other
Enumeration date
03/02/2010
Last updated
02/24/2016
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