MEDICARE: WARWICK FAMILY BASED PROGRAM, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	105120	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447575006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARWICK FAMILY BASED PROGRAM, INC.

Provider Business Mailing Address
First Line	:	800 CLARMONT AVE
Second Line	:	SUITE B
City	:	BENSALEM
State	:	PA
Zip	:	19020-5705
Country	:	US
Telephone Number	:	267-525-7000
Fax Number	:	267-525-7010

Provider Business Practice Location Address
First Line	:	500 EAST STATION AVE
Second Line	:
City	:	COOPERSBURG
State	:	PA
Zip	:	18036-2028
Country	:	US
Telephone Number	:	267-525-7000
Fax Number	:	267-525-7010

Authorized Official
Title or Position	:	CEO
Name	:	MR. KENNETH W. BROWNELL
Credential	:
Telephone Number	:	267-525-7000

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/07/2010

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