Healthcare Provider Details

I. General information

NPI: 1508524224
Provider Name (Legal Business Name): ON MY WAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 STONEHAVEN DR
TOWNSEND DE
19734-3812
US

IV. Provider business mailing address

PO BOX 1045
MIDDLETOWN DE
19709-7045
US

V. Phone/Fax

Practice location:
  • Phone: 718-413-6632
  • Fax:
Mailing address:
  • Phone: 718-413-6632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE WILIAMS
Title or Position: DIRECTOR
Credential:
Phone: 718-413-6632