NPIMap

Organization Active NPI

Provisions Home Healthcare Services,LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1750730586
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
30023601 Issued in PA
Legal business name
PROVISIONS HOME HEALTHCARE SERVICES,LLC
Practice address
10067 Sandmeyer LN
Suite 212
Philadelphia, PA 19116-3533
Phone
(215) 399-9766
NPI assigned
Jun 13, 2016
Last updated
Jun 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Authorized official

Name
Jennifer Clerisson, RN BSNNPI 1730624651
Title
Administrator
Phone
(215) 399-9766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 30023601 PA Primary

Addresses

Primary practice location

10067 Sandmeyer LN
Suite 212
Philadelphia, PA 19116-3533

Mailing address

10067 Sandmeyer LN
Suite 212
Philadelphia, PA 19116-3533
Phone (215) 399-9766

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1750730586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10067 SANDMEYER LN",
            "address_2": "SUITE 212",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163533",
            "telephone_number": "215-399-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10067 SANDMEYER LN",
            "address_2": "SUITE 212",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163533",
            "telephone_number": "215-399-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISIONS HOME HEALTHCARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "CLERISSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-399-9766",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "30023601",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 13, 2016; 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.