Healthcare Provider Details

I. General information

NPI: 1619348919
Provider Name (Legal Business Name): MORAVIAN CENTER ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 N. QUEEN STREET
LANCASTER PA
17603
US

IV. Provider business mailing address

227 NORTH QUEEN STREET
LANCASTER PA
17603
US

V. Phone/Fax

Practice location:
  • Phone: 717-490-6225
  • Fax: 717-553-5962
Mailing address:
  • Phone: 717-490-6225
  • Fax: 717-553-5962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number265534
License Number StatePA

VIII. Authorized Official

Name: MRS. ZOE ANN BRACCI
Title or Position: DIRECTOR
Credential:
Phone: 717-490-6225