Healthcare Provider Details
I. General information
NPI: 1346784030
Provider Name (Legal Business Name): SARAHCARE OF MALVERN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2016
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
425 TECHNOLOGY DR
MALVERN PA
19355-1314
US
IV. Provider business mailing address
425 TECHNOLOGY DR
MALVERN PA
19355-1314
US
V. Phone/Fax
- Phone: 610-251-0801
- Fax:
- Phone: 610-251-0801
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | 275730 |
| License Number State | PA |
VIII. Authorized Official
Name:
JENNIFER
MATHIS-DEVINE
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential:
Phone: 610-251-0801