| Organization Name: | FORT HOME CARE AGENCY LLC |
| NPI Number: | 1114319456 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YURIY REDTSCHITZ (OWNER/DIRECTOR) |
| Mailing Address: | 449 Veit Rd Huntingdon Valley |
| State: | PA US |
| Postal Code: | 190061617 |
| Phone Number: | 2157762459 |
| Fax Number: | 4847322030 |
| NPI Enumeration Date: | 02/24/2015 |
| NPI Last Update Date: | 02/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 22943601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |