Healthcare Provider Details

I. General information

NPI: 1457617813
Provider Name (Legal Business Name): PHOEBE CORPORATE AND COMMUNITY BASED SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 READING DR
WERNERSVILLE PA
19565-2018
US

IV. Provider business mailing address

1925 W TURNER ST
ALLENTOWN PA
18104-5513
US

V. Phone/Fax

Practice location:
  • Phone: 610-927-8560
  • Fax:
Mailing address:
  • Phone: 610-794-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT R STEVENSON
Title or Position: PRESIDENT/CEO/CFO
Credential:
Phone: 610-794-5142