Healthcare Provider Details

I. General information

NPI: 1265858914
Provider Name (Legal Business Name): CARELINK COMMUNITY SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S LANSDOWNE AVE
LANSDOWNE PA
19050-2330
US

IV. Provider business mailing address

106 CHESLEY DR
MEDIA PA
19063-1759
US

V. Phone/Fax

Practice location:
  • Phone: 610-626-6442
  • Fax: 610-626-2336
Mailing address:
  • Phone: 610-874-1119
  • Fax: 610-565-3801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: GARY WOOMER
Title or Position: COO
Credential:
Phone: 610-874-1119