Healthcare Provider Details

I. General information

NPI: 1477949139
Provider Name (Legal Business Name): CARE AT HOME OF DELAWARE VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CENTER MILL RD
CHADDS FORD PA
19317-9212
US

IV. Provider business mailing address

102 CENTER MILL RD
CHADDS FORD PA
19317-9212
US

V. Phone/Fax

Practice location:
  • Phone: 302-442-3600
  • Fax:
Mailing address:
  • Phone: 302-442-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number27323601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MORRIS PETERZELL
Title or Position: PHYSICIAN
Credential: D.O
Phone: 302-442-3600