NPIMap

Organization Active NPI

Immanuel Care Support Services

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1003203571
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
IMMANUEL CARE SUPPORT SERVICES
Practice address
6641 Dorel St
Philadelphia, PA 19142-2618
Phone
(267) 403-8313
NPI assigned
Apr 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Hawa A Kamara
Title
President/Ceo
Phone
(267) 403-8313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X PA
In Home Supportive Care Agency 253Z00000X PA Primary

Addresses

Primary practice location

6641 Dorel St
Philadelphia, PA 19142-2618

Mailing address

6641 Dorel St
Philadelphia, PA 19142-2618
Phone (267) 403-8313

Other identifiers 1

IdentifierTypeStateIssuer
4345180MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1003203571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6641 DOREL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191422618",
            "telephone_number": "267-403-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6641 DOREL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191422618",
            "telephone_number": "267-403-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL CARE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "KAMARA",
        "authorized_official_first_name": "HAWA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "267-403-8313",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4345180",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.