Healthcare Provider Details

I. General information

NPI: 1215885157
Provider Name (Legal Business Name): WITH YOU, I AM HOME RESIDENTIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 SUMMIT ST
MARCUS HOOK PA
19061-4339
US

IV. Provider business mailing address

1544 SUMMIT ST
MARCUS HOOK PA
19061-4339
US

V. Phone/Fax

Practice location:
  • Phone: 484-268-9963
  • Fax:
Mailing address:
  • Phone: 484-268-9963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MIYA MADISON
Title or Position: OWNER
Credential:
Phone: 484-268-9963