Healthcare Provider Details

I. General information

NPI: 1639004823
Provider Name (Legal Business Name): ROOTED COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 E PHILADELPHIA ST
YORK PA
17401-1124
US

IV. Provider business mailing address

2536 EASTERN BLVD # 301
YORK PA
17402-2914
US

V. Phone/Fax

Practice location:
  • Phone: 717-900-5588
  • Fax:
Mailing address:
  • Phone: 717-900-5588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DELIA GARDNER
Title or Position: CO-OWNER
Credential:
Phone: 717-900-5588