Provider Demographics
NPI:1548862311
Name:AUGUST HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:AUGUST HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WYCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-974-6619
Mailing Address - Street 1:5300 W JEFFERSON ST UNIT 28198
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-3375
Mailing Address - Country:US
Mailing Address - Phone:267-888-7121
Mailing Address - Fax:
Practice Address - Street 1:110 S 53RD ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3436
Practice Address - Country:US
Practice Address - Phone:267-888-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care