Healthcare Provider Details
I. General information
NPI: 1952434789
Provider Name (Legal Business Name): ELWYN OF PENNSYLVANIA AND DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2007
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 E OLD BALTIMORE PIKE
MEDIA PA
19063-4604
US
IV. Provider business mailing address
111 ELWYN RD
MEDIA PA
19063-4622
US
V. Phone/Fax
- Phone: 215-891-2000
- Fax:
- Phone: 610-891-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BROOKE
MCLAUGHLIN
Title or Position: CONTRACTS & CREDENTIALING COORD.
Credential:
Phone: 919-896-3581