39D1063707 CLIA NUMBER - INDEPENDENT HOME CARE

Laboratory Demographics

CLIA Number: 39D1063707

Facility Name: INDEPENDENT HOME CARE

Facility Address:
9892 BUSTLETON AVENUE SUITE 203
PHILADELPHIA, PA
ZIP 19115
Get Directions

Facility Phone Number: 215 821-3078

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1619367489

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	39D1063707
LAB Type	Home Health Agency
Facility Name	INDEPENDENT HOME CARE
Street	9892 BUSTLETON AVENUE SUITE 203
City	PHILADELPHIA
State	PA
ZIP	19115
Phone	215 821-3078
CertificateType	4
CertificateEffectiveDate	1/19/2023
CertificateExpirationDate	1/18/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024