Organization Active NPI

United Homecare Support Inc

  • Adult Development & Aging Psychologist
  • Philadelphia, PA
National Provider Identifier
1861182610
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Legal business name
UNITED HOMECARE SUPPORT INC
Practice address
6350 Greene St Apt 314
Philadelphia, PA 19144-2528
Phone
(443) 635-1657
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Busayo Dickson Ajayi
Title
Ceo
Phone
(443) 635-1657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X Primary

Addresses

Primary practice location

6350 Greene St Apt 314
Philadelphia, PA 19144-2528

Mailing address

6350 Greene St Apt 314
Philadelphia, PA 19144-2528
Phone (443) 635-1657

Other identifiers 1

IdentifierTypeStateIssuer
8976HTMedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1861182610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 GREENE ST APT 314",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442528",
            "telephone_number": "443-635-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 GREENE ST APT 314",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442528",
            "telephone_number": "443-635-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HOMECARE SUPPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "BUSAYO",
        "authorized_official_middle_name": "DICKSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-635-1657"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976HT",
            "state": "PA"
        }
    ],
    "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 May 22, 2023; 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.