Organization Active NPI

Excellent Support Services

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1972151082
Registry record updated Sep 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
EXCELLENT SUPPORT SERVICES
Practice address
1801 S 58TH St Ste 1
Philadelphia, PA 19143-5501
Phone
(267) 259-8962
NPI assigned
Sep 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2019

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

Authorized official

Name
Kollie Kabbah
Title
Chief Executive Officer (Ceo)
Phone
(267) 259-8962

Specialties & licenses 1

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

Addresses

Primary practice location

1801 S 58TH St Ste 1
Philadelphia, PA 19143-5501

Mailing address

1801 S 58TH St Ste 1
Philadelphia, PA 19143-5501

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Philadelphia Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1801 S 58th St
Ste 1
Philadelphia, PA 19143
Phone (267) 259-8962

NPI Registry JSON

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

{
    "created_epoch": "1567296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567296000000",
    "number": "1972151082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S 58TH ST STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S 58TH ST STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435501",
            "telephone_number": "267-259-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-01",
        "last_updated": "2019-09-01",
        "status": "A",
        "authorized_official_last_name": "KABBAH",
        "authorized_official_first_name": "KOLLIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER (CEO)",
        "authorized_official_telephone_number": "267-259-8962"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Philadelphia",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1801 S 58th St Ste 1",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191435501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 1, 2019; 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.