=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720637382
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHANDLER HALL HEALTH SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2019
-----------------------------------------------------
Last Update Date | 09/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 99 BARCLAY ST
-----------------------------------------------------
City | NEWTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18940-1593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-291-2290
-----------------------------------------------------
Fax | 267-291-2269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 99 BARCLAY ST
-----------------------------------------------------
City | NEWTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18940-1593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-291-2210
-----------------------------------------------------
Fax | 267-291-2219
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. DIRECTOR FINANCE
-----------------------------------------------------
Name | MICHAEL MCGLONE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 267-291-2210
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------