Provider Demographics
NPI:1144845546
Name:PASSIONATELY CARING FOR YOU LLC
Entity type:Organization
Organization Name:PASSIONATELY CARING FOR YOU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAQUITE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-800-4840
Mailing Address - Street 1:1229 N OLMSTED PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9994
Mailing Address - Country:US
Mailing Address - Phone:215-800-4840
Mailing Address - Fax:
Practice Address - Street 1:111 MACDADE BLVD APT C15
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-2927
Practice Address - Country:US
Practice Address - Phone:215-800-4840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health