Provider Demographics
NPI:1518775006
Name:CARE BRIDGE HOME SERVICES LLC
Entity type:Organization
Organization Name:CARE BRIDGE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-901-5305
Mailing Address - Street 1:2200 BENJAMIN FRANKLIN PKWY APT E1114
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3761
Mailing Address - Country:US
Mailing Address - Phone:267-901-5305
Mailing Address - Fax:215-561-4677
Practice Address - Street 1:6140 N 20TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2419
Practice Address - Country:US
Practice Address - Phone:267-901-5305
Practice Address - Fax:215-561-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care