MEDICARE: PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1780310938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC

Provider Business Mailing Address
First Line	:	2000 WESTINGHOUSE DR STE 200
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5238
Country	:	US
Telephone Number	:	724-343-4060
Fax Number	:

Provider Business Practice Location Address
First Line	:	17425 OCEAN ONE PLZ UNIT 4
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-1924
Country	:	US
Telephone Number	:	302-875-8640
Fax Number	:	302-875-8642

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	BRENDA METAL-CONFER
Credential	:
Telephone Number	:	724-448-2733

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	07/29/2022

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