Credence Home Care Agency, Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

31213601 Issued in PA

Legal business name

CREDENCE HOME CARE AGENCY, INC

Doing business as

Credence Eldercare Services

Practice address

1415 N Broad St Ste 118
Philadelphia, PA 19122-3324

Phone

(215) 764-5529

Fax

(215) 825-8406

NPI assigned

Jan 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Cajetan Onuoha

Title

Administrator

Phone

(215) 764-5529

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 2

• Credence Eldercare Services Doing business as
• Credence Home Care Agency Inc Former legal business name

Locations

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1750611323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N BROAD ST STE 118",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191223324",
            "telephone_number": "215-764-5529",
            "fax_number": "215-825-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N BROAD ST STE 118",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191223324",
            "telephone_number": "215-764-5529",
            "fax_number": "215-825-8406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1531 W Tioga St Apt 100",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405038",
            "country_code": "US",
            "telephone_number": "267-457-5832",
            "fax_number": "267-457-5819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CREDENCE HOME CARE AGENCY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "ONUOHA",
        "authorized_official_first_name": "CAJETAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-764-5529",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "31213601",
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "315964",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": "PA",
            "license": "31213601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102499867",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Credence Eldercare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Credence Home Care Agency Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• In Home Supportive Care Agency in Philadelphia, PA
• Providers in Philadelphia, 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 Jun 16, 2018; 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.