Provider Demographics
NPI:1548855679
Name:HOMESENSE LLC
Entity type:Organization
Organization Name:HOMESENSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEFEDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-275-7921
Mailing Address - Street 1:809 BARNSWALLOW LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-2110
Mailing Address - Country:US
Mailing Address - Phone:267-307-0016
Mailing Address - Fax:215-689-1904
Practice Address - Street 1:1300 INDUSTRIAL BLVD STE B3
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4029
Practice Address - Country:US
Practice Address - Phone:217-275-7921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care