MEDICARE: DELTA COMMUNITY SUPPORTS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	253Z00000X	In Home Supportive Care Agency
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174903017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA COMMUNITY SUPPORTS, INC.

Provider Business Mailing Address
First Line	:	1777 SENTRY PKWY W
Second Line	:	GWYNEDD HALL, SUITE 400
City	:	BLUE BELL
State	:	PA
Zip	:	19422-2207
Country	:	US
Telephone Number	:	215-654-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	431 OLD RIVER RD
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-1610
Country	:	US
Telephone Number	:	609-625-8054
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DAVID A. WYHER
Credential	:
Telephone Number	:	215-654-1000

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	06/05/2015

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