Healthcare Provider Details

I. General information

NPI: 1871513648
Provider Name (Legal Business Name): HARWOOD HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 WEST CHESTER PIKE
UPPER DARBY PA
19082-2608
US

IV. Provider business mailing address

9200 WEST CHESTER PIKE
UPPER DARBY PA
19082-2608
US

V. Phone/Fax

Practice location:
  • Phone: 610-853-3440
  • Fax: 610-853-1067
Mailing address:
  • Phone: 610-853-3440
  • Fax: 610-853-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number232156
License Number StatePA

VIII. Authorized Official

Name: MRS. JOY ANN DOUGLAS JR.
Title or Position: EXECUTIVE DIRECTOR
Credential: BACHELORS
Phone: 610-853-3440