Healthcare Provider Details

I. General information

NPI: 1992763908
Provider Name (Legal Business Name): CHADDS FORD ALTERNACARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CHRISTY DRIVE SUITE 104
CHADDS FORD PA
19317-9682
US

IV. Provider business mailing address

5 CHRISTY DRIVE SUITE 104
CHADDS FORD PA
19317-9682
US

V. Phone/Fax

Practice location:
  • Phone: 610-675-1111
  • Fax: 610-675-1112
Mailing address:
  • Phone: 610-675-1111
  • Fax: 610-675-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number765305
License Number StatePA

VIII. Authorized Official

Name: ROBERT C PANACCIO
Title or Position: CEO
Credential: MSS
Phone: 610-675-1111