Healthcare Provider Details

I. General information

NPI: 1043577976
Provider Name (Legal Business Name): GUAVA HOMECARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 04/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 VALLEY BROOK DR
HOCKESSIN DE
19707-9113
US

IV. Provider business mailing address

407 VALLEY BROOK DR
HOCKESSIN DE
19707-9113
US

V. Phone/Fax

Practice location:
  • Phone: 302-399-6389
  • Fax: 302-482-4300
Mailing address:
  • Phone: 302-399-6389
  • Fax: 302-482-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHAAO0022
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License NumberHHAAO0022
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberHHAAO0022
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberHHAAO0022
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberHHAAO0022
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHHAAO0022
License Number StateDE
# 7
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberHHAAO0022
License Number StateDE

VIII. Authorized Official

Name: DR. MARY S SCHREIBER
Title or Position: CEO
Credential: PHD
Phone: 302-399-6389