Healthcare Provider Details

I. General information

NPI: 1033597638
Provider Name (Legal Business Name): CATHOLIC HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 RIDGE AVE
SOUDERTON PA
18964-1442
US

IV. Provider business mailing address

228 RIDGE AVE
SOUDERTON PA
18964-1442
US

V. Phone/Fax

Practice location:
  • Phone: 267-219-7986
  • Fax: 267-382-0109
Mailing address:
  • Phone: 267-219-7986
  • Fax: 267-382-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number285504
License Number StatePA

VIII. Authorized Official

Name: SHIRLEY WEAVER
Title or Position: DIRECTOR COMMUNITY BASED SERVICES
Credential: OTR/L MSOL
Phone: 215-587-2663