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General NPI Number Information
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NPI Number | 1447387105
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Entity Type | Organization
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Legal Business Name | DELTA COMMUNITY SUPPORTS INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 904 SUMNEYTOWN PIKE SUITE 200
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City | LOWER GWYNEDD
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State | PA
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Zip | 19002-1321
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Country | US
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Telephone | 215-654-1000
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Fax | 215-641-0393
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Provider Business Mailing Address
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Address Line | 904 SUMNEYTOWN PIKE SUITE 200
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City | LOWER GWYNEDD
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State | PA
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Zip | 19002-1305
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Country | US
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Telephone | 215-654-1000
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Fax | 215-641-0393
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID WYHER
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Credential |
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Telephone | 215-654-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS007042L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL001211L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 130440
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License Number State | PA
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