WHITE LILY HOME CARE INC (NPI# 1164875696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164875696 |
| Entity Type | Organization |
| Organization Name | WHITE LILY HOME CARE INC |
| Practice Address |
4915 Wynnefield Avenue 1af Wynnefield Heights PA 19131 |
| Practice Telephone | 2158747444 |
| Mailing Telephone | 2158747444 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | MS. MARIE TONDALAYA CLACK (PRESIDENT/ADMINISTRATOR) |
| Authorized Official Telephone | 2158747444 |
| Authorized Official Credential | LPN, BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
30513601 | PA | Nursing & Custodial Care Facilities |
| Street Address |
4915 WYNNEFIELD AVENUE 1AF |
| City | WYNNEFIELD HEIGHTS |
| State | PA |
| Zip Code | 19131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629678925 | Jonathan Welch | Student in an Organized Health Care Education/Training Program | 4200 E City Ave, Rowland Hall, Suite 207, Physician Assistant Department, Philadelphia, PA 19131 | 2020-10-27 |
| 1659970689 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 1575 North 25nd Street, Philadelphia, PA 19131 | 2020-10-21 |
| 1821629254 | Stephen Osowski | Student in an Organized Health Care Education/Training Program | 4170 City Avenue, Philadelphia, PA 19131 | 2020-02-04 |
| 1134774888 | Arti D Mistry | Dentist | 1126 Horsham Road, Philadelphia, PW 19131 | 2019-08-08 |
| 1275187221 | Grace Bernadette Farrelly | Occupational Therapist | 2101 Simpson House, Philadelphia, PA 19131 | 2019-07-29 |
| 1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
| 1922502582 | Kevin David Wojcik | Student in an Organized Health Care Education/Training Program | Philadelphia College of Osteopathic Medicine, 4190 City Ave, Philadelphia, PA 19131 | 2018-03-20 |
| 1235633900 | Nadja Hill | Home Health | 5203 Diamond Street, Philadelphia, PA 19131 | 2018-03-19 |
| 1932623857 | Mercy Management of Sepa | Social Worker | 1575 N 52nd St Ste 800, Philadelphia, PA 19131 | 2017-08-02 |
| 1578092235 | Sarah Marie Hoder | Specialist/Technologist | 4000 Presidential Avenue, Philadlephia, PA 19131 | 2017-06-07 |
| Find all providers in zip 19131 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837218 | Felix Hernandez | Custodial Care Facility | 814 Saint Paul St, Lewisburg, PA 17837-1210 | 2019-12-04 |
| 1811483084 | Silvercare Personal Care LLC | Custodial Care Facility | 34 Copley Rd, Upper Darby, PA 19082-2512 | 2018-07-10 |
| 1265963391 | Sunil Senior Care LLC | Custodial Care Facility | 220 E Chelten Ave, Philadelphia, PA 19144 | 2017-03-21 |
| 1295275519 | Nonprofit Development Corporation | Custodial Care Facility | 921 Grant Ave, East Butler, PA 16029 | 2017-03-06 |
| 1043661341 | Xzavier Hunter | Custodial Care Facility | 7007 York Rd, Abbottstown, PA 17301-9774 | 2016-06-28 |
| 1801292990 | Alpa Care Concepts | Custodial Care Facility | 6649 Woodland Ave, Philadelphia, PA 19142-1621 | 2014-11-17 |
| 1376971135 | Pocono Tranquil Gardens, LLC | Custodial Care Facility | 329 E Brown St, East Stroudsburg, PA 18301-3014 | 2013-10-14 |
| 1205273943 | Golden Age Care LLC | Custodial Care Facility | 716 Red Lion Rd, Philadelphia, PA 19115-1307 | 2013-06-03 |
| 1689913196 | Keystone Independent Living | Custodial Care Facility | 202 Boulevard Ave, Peckville, PA 18452-1002 | 2013-02-04 |
| 1801134648 | Just One Nurse | Custodial Care Facility | 5425 Wynnefield Ave, Philadelphia, PA 19131-1323 | 2013-01-29 |
| Find all providers with the same taxonomy | ||||
| City | WYNNEFIELD HEIGHTS |
| Zip Code | 19131 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.