=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366178428
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHOENIX REHABILITATION AND HEALTH SERVICES OF DELAWARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2022
-----------------------------------------------------
Last Update Date | 02/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 37031 OLD MILL BRIDGE RD UNIT 2
-----------------------------------------------------
City | SELBYVILLE
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19975-3940
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-564-7476
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 392573
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15251-9573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-343-4060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR, RCM SUPPORT
-----------------------------------------------------
Name | ERIN MCKINNEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 412-339-1063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------