Provider Demographics
NPI:1528510427
Name:PROMISECARE
Entity type:Organization
Organization Name:PROMISECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLEH
Authorized Official - Middle Name:KOU
Authorized Official - Last Name:WEHYE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MS
Authorized Official - Phone:267-312-2986
Mailing Address - Street 1:5216 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-2627
Mailing Address - Country:US
Mailing Address - Phone:267-312-2986
Mailing Address - Fax:
Practice Address - Street 1:5216 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-2627
Practice Address - Country:US
Practice Address - Phone:267-312-2986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25100000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health