Healthcare Provider Details

I. General information

NPI: 1083769814
Provider Name (Legal Business Name): TABOR CHILDREN'S SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 E ARMAT ST
PHILADELPHIA PA
19144-2201
US

IV. Provider business mailing address

601 NEW BRITAIN RD
DOYLESTOWN PA
18901-2788
US

V. Phone/Fax

Practice location:
  • Phone: 215-842-4800
  • Fax: 215-842-4809
Mailing address:
  • Phone: 215-842-4800
  • Fax: 215-348-9261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number1000038560002
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1000038560010
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT EDWARD HAUSSMANN
Title or Position: CHIEF INFORMATION OFFICER
Credential: PH.D.
Phone: 215-842-4800