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NPI Code Detail

MEDICARE: DELTA COMMUNITY SUPPORTS, INC.

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 License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2253Z00000XIn Home Supportive Care Agency
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1700267275
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 : 1543 FRONT ST
Second Line : SCOTCH PLAINS GARDENS
City : SCOTCH PLAINS
State : NJ
Zip : 07076-1175
Country : US
Telephone Number : 908-322-0207
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : DAVID A. WYHER
Credential :
Telephone Number : 215-654-1000
Provider Enumeration Date : 06/10/2015
Last Update Date : 06/10/2015

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Directions to “DELTA COMMUNITY SUPPORTS, INC. ” Practice Location

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