Provider Demographics
NPI:1043023484
Name:DDS PREFERRED HOME CARE AGENCY
Entity type:Organization
Organization Name:DDS PREFERRED HOME CARE AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DORETHA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:223-207-3417
Mailing Address - Street 1:55 S PROGRESS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4600
Mailing Address - Country:US
Mailing Address - Phone:223-207-3417
Mailing Address - Fax:
Practice Address - Street 1:55 S PROGRESS AVE STE 2
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4600
Practice Address - Country:US
Practice Address - Phone:223-207-3417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health