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General NPI Number Information
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NPI Number | 1679116628
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Entity Type | Organization
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Legal Business Name | SPECIALIZED ASSISTIVE RESIDENTIAL AND HABILATION SERVICES LLC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 433 INDIAN WAY
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City | EAST STROUDSBURG
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State | PA
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Zip | 18302-7901
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Country | US
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Telephone | 866-472-7247
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 ROUTE 940 STE 104-339
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City | MOUNT POCONO
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State | PA
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Zip | 18344-1183
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Country | US
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Telephone | 866-472-7247
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MR. DARYL THOMAS
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Credential |
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Telephone | 866-472-7247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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