Healthcare Provider Details

I. General information

NPI: 1821724980
Provider Name (Legal Business Name): PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MIDDLEFORD RD STE 203
SEAFORD DE
19973-3649
US

IV. Provider business mailing address

2000 WESTINGHOUSE DR STE 200
CRANBERRY TOWNSHIP PA
16066-5238
US

V. Phone/Fax

Practice location:
  • Phone: 302-404-5613
  • Fax: 302-404-5616
Mailing address:
  • Phone: 412-567-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRENDA METAL-CONFER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 724-584-5739