Shady Pines Ma Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SHADY PINES MA INC.

Doing business as

Qualicare Home Care King of Prussia, West Chester & Media

Practice address

426 W Gay St
West Chester, PA 19380-2801

Phone

(484) 639-9997

NPI assigned

Aug 19, 2025

Last updated

Aug 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Igbanol

Title

Owner & Administrator

Phone

(267) 316-8727

Specialties & licenses 1

Addresses

Other names 1

• Qualicare Home Care King of Prussia, West Chester & Media Doing business as

Locations

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1477430759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 W GAY ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193802801",
            "telephone_number": "484-639-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 W GAY ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193802801",
            "telephone_number": "484-639-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY PINES MA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "IGBANOL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER & ADMINISTRATOR",
        "authorized_official_telephone_number": "267-316-8727",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Qualicare Home Care King of Prussia, West Chester & Media",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in West Chester, PA
• Providers in West Chester, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.