Active NPI
United Homecare Support Inc
- Adult Development & Aging Psychologist
- Philadelphia, PA
National Provider Identifier
1861182610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8976HT | Medicaid | PA |
National Provider Directory
National Provider DirectoryNPI 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.