Safe Harbor 2 Home Care Agency, LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

SAFE HARBOR 2 HOME CARE AGENCY, LLC

Practice address

2418 N 15TH St
Philadelphia, PA 19132-4435

Phone

(215) 430-3032

NPI assigned

May 15, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Chiquita McGough

Title

Owner

Phone

(215) 430-3032

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1265054977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 N 15TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191324435",
            "telephone_number": "215-430-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 N 15TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191324435",
            "telephone_number": "215-430-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR 2 HOME CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "MCGOUGH",
        "authorized_official_first_name": "CHIQUITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-430-3032",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037276080001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "safeharborhomecare@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2418 N 15th St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191324435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.