Modacare Home Care Agency LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MODACARE HOME CARE AGENCY LLC

Practice address

9200 Bustleton Ave Apt 906
Philadelphia, PA 19115-4223

Phone

(267) 974-0771

NPI assigned

Jun 30, 2021

Last updated

Jun 30, 2021By 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

Erica Brefo Matthews

Title

Owner

Phone

(267) 974-0771

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1669042719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BUSTLETON AVE APT 906",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154223",
            "telephone_number": "267-974-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 BUSTLETON AVE APT 906",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154223",
            "telephone_number": "267-974-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODACARE HOME CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "BREFO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-974-0771"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.